[Asymptomatic gastric phytobezoar and anaemia due to iron deficiency revealing an autoimmune gastritis].
This observation recalls that gastric phytobezoar should lead to a search for an underlying disease and that a iron deficiency can be associated and hide macrocytosis related to a vitamin B12 deficiency.


METHODS
A 19 year-old woman consulted for asthenia. Microcyte anaemia associated with iron deficiency was diagnosed. Upper digestive endoscopy revealed severe, totally asymptomatic phytobezoar. Biological investigations revealed a vitamin B12 deficiency, high serum gastrin level and strong positivity for gastric antiparietal anti-cell antibodies, suggestive of an autoimmune gastritis. Total immunoglobulin A deficiency was also noted.


CONCLUSIONS
Autoimmune gastritis is responsible for megaloblastic anaemia (vitamin B12 deficiency) but can also provoke microcytic (iron-deficiency) anaemia due to insufficient absorption of the latter and related to gastric achlorhydria. Phytobezoar might also be related to achlorhydria and/or gastroparesia associated with autoimmune gastritis. Hence, autoimmune gastritis should be searched for when confronted with unexplained gastric bezoar or iron-deficiency anaemia.
Granel
B
B
Service de médecine Interne, Hôpital de la Timone, Marseille.
Serratrice
J
J
Disdier
P
P
Laugier
R
R
Weiller
P-J
PJ
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000150:complications* / Q000175:diagnosis*; D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D001630:Bezoars / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D010944:Plants; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000175:diagnosis*
D005755:Gastrins