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

被引:4
|
作者
Cittolin-Santos, G. F. [1 ]
Khalil, S. [1 ]
Bakos, J. K. [1 ]
Baker, K. [1 ]
机构
[1] Med Univ South Carolina, Dept Internal Med, Charleston, SC 29425 USA
关键词
COBALAMIN DEFICIENCY; PERNICIOUS-ANEMIA; DIAGNOSIS;
D O I
10.1155/2020/8697493
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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页数:4
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