Burnout and well-being in obstetricians and gynaecologists in Hong Kong: a territory-wide cross-sectional survey.

Ménétrier disease (MD) is a rare, acquired premalignant protein-losing gastropathy characterized by diffuse hypertrophy of the gastric mucosal folds, massive foveolar hyperplasia, and atrophy of the oxyntic glands (). The pathogenesis remains incompletely understood but is fundamentally driven by the overexpression of transforming growth factor-alpha (TGF-α) and the subsequent overactivation of the epidermal growth factor receptor (EGFR) signaling pathway (). While the disease primarily afflicts the adult population, where it follows a chronic, progressive course with a notable risk of malignant transformation to gastric cancer (), pediatric MD is exceedingly rare and exhibits a distinctly different clinical trajectory. In children, MD is typically characterized by an acute onset and a self-limiting course. It is frequently triggered by antecedent infections, most notably Cytomegalovirus (CMV) () and (Hp), though other atypical agents like Epstein–Barr virus (EBV) () and () have been occasionally implicated. The classic clinical features of pediatric MD include gastrointestinal symptoms, peripheral edema, and severe hypoalbuminemia resulting from a protein-losing gastropathy, where serum proteins are exuded across the hypertrophic gastric mucosa (). However, the heterogeneity of clinical phenotypes often leads to misdiagnosis or delayed treatment. Current literature on pediatric MD consists predominantly of isolated case reports and small case series, lacking large-scale epidemiological data (). Particularly in the Chinese pediatric population, reports are scattered, and there is a critical absence of systematically aggregated cohort characteristics. To further elucidate the clinical profile of this rare condition, and elevate the methodological rigor of current evidence, this study was designed in accordance with the international writing standards of the EQUATOR Network. We detail a comprehensively documented pediatric MD case from our institution (following the CARE guidelines) and perform a systematic review of all reported domestic cases adhering to the PRISMA guidelines. By consolidating these data and evaluating the risk of bias, we aim to systematically summarize the epidemiological, clinical, and pathological features of MD in Chinese children, thereby optimizing the diagnostic algorithm and therapeutic strategies for this rare entity.