Lymphocytic gastritis is characterized by intense lymphocytic infiltration
of gastric epithelium. Excessive gastric protein loss is uncommon. We descr
ibe the case of a 49-year-old white woman suffering from generalized edema
and abdominal pain. She had severe serum hypoproteinemia, hypoalbuminemia a
nd hypogammaglobulinemia. There was no renal cardiac or hepatic origin of p
rotein loss, and no protein-losing enteropathy. Endoscopic examination show
ed diffuse varioliform gastritis and histology confirmed lymphocytic gastri
tis with > 30% intraepithelial lymphocytes without Helicobacter pylori. The
protein loss stopped within two weeks of the beginning of omeprazole and e
xtensive edema disappeared. Four years later, the patient was still free fr
om edema. Inflammatory involvement of the gastric mucosa probably caused pr
otein losing in this patient. Recognition of this exsudative gastropathy is
important because long term remission is obtained with omeprazole.