Anti-fibrinolytic Therapy of Giant Hypertrophic Gastritis (Menetrier's Disease)

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Abstract
In 5 cases of giant hypertrophic gastritis (Menetrier''s disease) biopsied gastric mucosa was examined for fibrinolytic activity; in all cases there was marked elevation of the activity due mainly to tissue plasminogen activator. The patients were given antifibrinolytic therapy with oral tranexamic acid (trans-4-aminomethyl cyclohexane carboxylic acid; trans-AMCHA), and 4 of the patients showed marked improvement of their hypoproteinemia as well as their mucosal disorders. One patient, who showed moderate increase of serum protein level but no reduction of the mucosal disorder, finally received gastrectomy. Antifibrinolytic therapy seemed to block the vicious circle of membrane disorder, increased tissue fibrinolytis, increased vascular permeability and hypoproteinemia in Menetrier''s disease.