Idiopathic transient edema and hypoproteinemia of childhood has been a recognized clinical entity for several years.1-5Recently studies have indicated that in the absence of proteinuria, increased intestinal degradation of protein (exudative enteropathy, protein-losing gastroenteropathy) plays an important role in the genesis of the edema and hypoproteinemia.6,7Unlike children who have had persistent edema and hypoproteinemia with increased gastrointestinal protein degradation,8-11only one of the patients with transient idiopathic edema and hypoproteinemia has had evidence of gastrointestinal pathology. This patient, a 3-year-old child reported by Degnan,5had "the presence and persistence of large gastric folds on gastrointestinal series, suggesting hypertrophic gastritis." The purpose of this paper is to report a case of transient severe edema and hypoproteinemia in a 5-year-old child who was shown to have increased intestinal degradation and decreased synthetic activity of albumin associated with transient giant hypertrophy of the gastric mucosa. Report of