[Protein-losing giant fold gastritis in childhood--a case report and differentiation from Ménétrier disease of adulthood].

We report on a 2.5-year-old boy, who presented with vomiting since one week and periorbital and pitting edema. Laboratory studies revealed hypoproteinemia and hypoalbuminemia without signs of renal or liver disease. The cause of protein loss was giant fold gastritis disclosed by upper endoscopy. Biopsies revealed foveolar hyperplasia with cystic dilatation of the glands, identical to Ménétrier's disease in adulthood. About 55 cases of hypertrophic gastropathy in children have been published. In contrast to the chronic course of Ménétrier's disease in adults, the pediatric cases are generally benign, self-limited with complete resolution typically within a few weeks. While the etiology of Ménétrier's disease is still unknown, the benign pediatric hypertrophic gastropathies have been associated with infections, primarily CMV and occasionally helicobacter pylori, herpes simplex and mycoplasma. Supportive treatment with a high-protein-diet and intravenous albumin transfusions is recommended. H2-receptor antagonists might improve symptoms.