title: [Asymptomatic gastric phytobezoar and anaemia due to iron deficiency revealing an autoimmune gastritis].
abstract: 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.
authors.affiliation: Service de médecine Interne, Hôpital de la Timone, Marseille.
authors.forename: B
authors.initials: B
authors.lastname: Granel
authors.forename: J
authors.initials: J
authors.lastname: Serratrice
authors.forename: P
authors.initials: P
authors.lastname: Disdier
authors.forename: R
authors.initials: R
authors.lastname: Laugier
authors.forename: P-J
authors.initials: PJ
authors.lastname: Weiller
mesh_terms: 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*
chemical_list: D005755:Gastrins