Gastric secretory derangement in Menetrier's disease

Summary Two cases of Menetrier's disease with occult gastrointestinal albumin loss, absence of free hydrochloric acid, and increased uropepsinogen excretion are presented.The absence of free hydrochloric acid is explained by the combination of edema and inflammatory reaction interfering with passage of the hydrochloric acid into the gastric cavity and its neutralization by the increased amount of albumin exuded into the stomach.The decrease in gastric pepsinogen secretion associated with an increased uropepsinogen excretion is probably due to a derangement of the normal exocrine-endocrine partition.The study reported in this article was supported by a Graduate Training Grant in Gastroenterology 2A-5177, National Institutes of Health Grant O6-22 from USPHS, and a special research fund.We are indebted to Dr. Robert B. Burton, Department of Medicine, for making Case I available for this study and to Dr. Roger Terry for interpretation of the histologic specimens.