Menetrier's disease

Menetrier's disease is one of the major causes of hypertrophic gastropathy and is characterised by giant cribriform (brain like) enlargement of the rugal folds of the gastric mucosa.


The etiology of the disease is unknown. The overexpression of growth factors such as TNF-alpha may be involved.

Clinical features

Menetrier's disease affects males more with a male:female ratio of 3: 1. The disease usually manifests in the in the fourth to sixth decade of life. The main symptoms due to the large gastric folds are diarrhoea, weight loss, bleeding and protein losing enteropathy.


The rugal enlargement is caused by hyperplasia of the mucosal epithelial cells (without inflammation), replacing the chief cells and the parietal cells.

Differential diagnosis

  • Zollinger ellison syndrome
  • Malignancies
  • Cytomegalovirus (CMV) infection
  • Histoplasmosis
  • Sarcoidosis

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