低蛋白血症を伴ったGiant Hypertrophic Gastritis（Ménétrier）の1例

A Case of Giant Hypertrophic Gastritis (Ménétrier's Disease) with Hypoproteinemia

　最近，われわれは著明な低蛋白血症と好酸球増多症を伴った特異な肥厚性胃炎の1例を経験，胃亜全剔により血清蛋白の著明な改善並びに好酸球増多症の相対的な改善をみたので，eosinophilic gastroenteritisとの関連等を含め，若干の文献的考察を加えて報告する．

　The patient is a 22-year-old male who was admitted to National Kanazawa Hospital with complaints of upper epigastric discomfort and occasional nausea of 6 months' duration. There was no peripheral edema. Une month before the admission, the patient threw up a bitter vomitus which contained a little fresh blood. Upper GI series showed enormously huge and tortuous folds extending from the junction of the fundus and the body of the stomach downward almost to angulus, associated with a large irregular mass similar to polypoid cancer at the lesser curvature of body. Endoscopy confirmed the presence of generalized giant hypertrophic gastritis throughout the stomach except for pyloric antrum. Protein analysis indicated hypoproteinemia (total protein value 4.8 g/dl) with an abnormal protein electrophoresis. Gastric analysis revealed low normal levels. It was concluded that he had giant hypertrophic gastritis with marked hypoproteinemia. At surgery the patient was found to have giant hypertrophic gastritis without evidence of malignancy, and 90% subtotal gastrectomy was performed with Billroth Ⅱ anastomosis. The patient made an uneventful recovery, and about one month later his total protein level was completely within normal limit with its value of 6.8 g/dl. At the time of this writing two years have passed since the operation. He gained much weight and is completely free from preoperative symptoms.