Marked gastric foveolar hyperplasia associated with active cytomegalovirusinfection

Transient protein-losing gastropathy with marked gastric rugal hypertrophy, a Menetrier's disease-like process, is an uncommon condition of unknown et iology. Most of these cases have been reported in pediatric patients; the c linical course is usually favorable. Cytomegalovirus infection has been imp licated as a possible etiology in many of the reported cases. This type of Menetrier's-like disease has not been well documented in adult patients. We describe here an elderly man who presented with severe protein-losing gast ropathy and large polypoid nodules in the stomach. Gastric mucosal biopsies revealed marked gastric foveolar hyperplasia with morphological evidence o f cytomegalovirus (CMV) infection. Immunohistochemical analysis demonstrate d an aberrant topographic distribution of staining for transforming growth factor-alpha and transforming growth factor-beta receptor II, as described in other cases of Menetrier's disease in the literature. This transient Men etrier's-like disease associated with CMV infection should be considered in the differential of both pediatric and adult patients with GI protein loss . (Am J Gastroenterol 2001;96:223-226. (C) 2001 by Am. Coll. of Gastroenter ology).