Pluricarential Anemia Secondary To AutoimmuneAtrophic Gastritis In A Young Female: Case Report

Abstract

value according to age and gender, and corresponds to a major global health problem.Most anemias originate from deficiency syndromes, and their etiology must always beinvestigated.Case Report: We report a 29-year-old female patient with refractory iron deficiencyanemia,even afterseveral attempts to oral iron replacement, associated with less pronouncedvitamin B12 deficiency. Pluricarential anemia and unresponsiveness to oraliron in therapeutic dosestriggered the diagnostic hypothesis of disabsorptive syndrome.Upper gastrointestinal endoscopy showed moderate gastric atrophy with active gastritisby histological evaluation and negative search for H. pylori. The evaluation of clinical,endoscopic and laboratory data (gastrin increase and positivity for anti-parietalcell antibody) provided the diagnosis of autoimmune atrophic gastritis. Parenteralreplacements of iron and vitamin B12 were performed with good response and the patientis been followed up with hematologists and gastroenterologists.Thus, wereport acase of a young patient with an uncommon presentation of iron deficiency.Discussion: The non-responsiveness to oral iron replacement should trigger researchinto some disabsorptive clinical entities such as celiac disease, Helicobacter pylori infectionand autoimmune atrophic gastritis.The latter may manifest with pluricarentialsyndromes (in particular by vitamin B12 deficiency, usually more pronounced, andiron deficiency).Nutrients malabsorption in autoimmune atrophic gastritis is due toblockade in H + / K + ATP-ase pump due to antibodies.Conclusion: Inadequate etiological investigation of anemia is an important causeof non-responsiveness to proposed treatments, with considerable morbidity for thepopulation involved and expenditures for health care.