Abstract
Hypertrophic protein-losing gastropathy is a rare clinical entity of unknown etiology. Seventeen of 50 GI Units in The Netherlands, surveying their patient material, documented at least 1 positive case. Altogether, 40 patients (25 male and 15 female; mean age, 44.3 years) fulfilled the usually accepted criteria. Main complaints were epigastric pain (65%), asthenia (60%), anorexia (45%), weight loss 45%, edema (37.5%), and vomiting (37.5%). Hypoalbuminemia of <35g/l was found in 81%, and an abnormal enteric protein loss (5lCrCl3) in 22 of 26 tested patients (85%). The mean basal acid output was 0.99 mmolH+/h. Stomach radiology in 35 patients showed giant folds mainly of the corpus mucosa; endoscopy confirmed the hypertrophy of the folds in all cases (in four confirmed by endosonography) and the presence of adherent mucus. Occasionally a concomitant gastric ulcer was found. Endoscopic biopsies were usually of limited value for the histologic diagnosis, mainly suggesting the possibility of hypertrophic gastr...
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