Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia

Case Reports in Hematology
G F Cittolin-SantosK Baker

Abstract

A 28-year-old Caucasian male with Hashimoto's disease and vitiligo presented with two weeks of dizziness on exertion following pharyngitis which was treated with prednisone 40 mg by mouth once a day for five days. Initial workup revealed anemia, elevated lactate dehydrogenase (LDH), and low haptoglobin. He underwent workup for causes of hemolytic anemia which was remarkable for a peripheral blood smear with hypersegmented neutrophils and low vitamin B12 levels concerning for pernicious anemia. Parietal cell and intrinsic factor antibodies were negative, and he then underwent an esophagogastroduodenoscopy with biopsy. The biopsy was negative for Helicobacter pylori, and the immunohistochemical stains were suggestive of chronic atrophic gastritis. He was started on vitamin B12 1,000 mcg intramuscular injections daily. His hemoglobin, LDH, and haptoglobin normalized. Given the absence of the parietal cell antibody and intrinsic factor antibody, this is a rare case of seronegative pernicious anemia.

References

Feb 8, 1997·BMJ : British Medical Journal·V Hoffbrand, D Provan
Nov 14, 1997·The New England Journal of Medicine·B H TohP A Gleeson
Nov 6, 2009·World Journal of Gastroenterology : WJG·Edith Lahner, Bruno Annibale
Jan 29, 2011·World Journal of Gastroenterology : WJG·Daniel Cattan
Oct 3, 2012·Journal of Blood Medicine·Emmanuel Andres, Khalid Serraj
Jan 11, 2013·The New England Journal of Medicine·Sally P Stabler
Jan 15, 2014·Autoimmunity Reviews·Garrett F BassJoseph M Tuscano

❮ Previous
Next ❯

Citations

Aug 11, 2021·Case Reports in Hematology·Amanda M WoodfordMadhurima Anne

❮ Previous
Next ❯

Methods Mentioned

BETA
electrophoresis
flow cytometry
biopsy

Related Concepts

Related Feeds

Atrophic Gastritis

Atrophic Gastritis is a process where gastric glandular cells are lost and replaced with firbous tissues, as a result of chronic inflammation. Learn more about Atrophic Gastritis here.

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.