Transient Protein-Losing Enteropathy and Enlarged Gastric Rugae-Reply

Abstract

In Reply .—I appreciate Dr Bloom's comments on our article in theJournal. However, several annotations to those comments are appropriate. My colleagues and I believe, as does Dr Bloom, that the coincidence of hypertrophic gastric folds and protein-losing enteropathy in children does not necessarily signify Menetrier's disease, which is a condition with a course that differs from that of the children whom we described in our article. We sought to identify a subgroup of such children on historical and epidemiologic criteria and found that available evidence suggested a similar origin or pathogenesis in several instances. Using our standards, I can accept the cases reported by Floret et al 1 (this patient also had evidence of cytomegalovirus infection) and by Gwinn and Lee 2 as similar to our cases. However, the case reported by Colon and Sandberg 3 is identical to the case reported by Sandberg 4 alone and was