In Reply.—I appreciate Dr Bloom's comments on our article in the Journal. However, several annotations to those comments are appropriate.
My colleagues and I believe, as does Dr Bloom, that the coincidence of hypertrophic gastric folds and protein-losing enteropathy in children does not necessarily signify Ménétrier's disease, which is a condition with a course that differs from that of the children whom we described in our article. We sought to identify a subgroup of such children on historical and epidemiologic criteria and found that available evidence suggested a similar origin or pathogenesis in several instances. Using our standards, I can accept the cases reported by Floret et al1 (this patient also had evidence of cytomegalovirus infection) and by Gwinn and Lee2 as similar to our cases. However, the case reported by Colon and Sandberg3 is identical to the case reported by Sandberg4 alone and was