title: [Severe anemia in a young woman. Description of a rare coincidence].
abstract: METHODS
  A 25-year-old woman was admitted because of severe anemia and exercise-induced tachypnea and dyspnea. She had no gastrointestinal symptoms and reported no allergies. The family history did not reveal any obvious or familial disease.
  
  
  METHODS
  Whole blood analysis showed severe macrocytic anemia. The vitamin B12 level was reduced and biopsies revealed autoimmune gastritis and typical megaloblastic changes in the bone marrow. Gastroscopy showed marked mucosal atrophy as seen in celiac disease. Vitamin B12 was administered parenterally and she was put on a gluten-free diet.
  
  
  CONCLUSIONS
  The combination of autoimmune gastritis and celiac sprue is most likely a variant of the polyglandular autoimmune syndrome type 2. Early diagnosis, life-long gluten-free diet and vitamin B12 administration as well as appropriate aftercare prevent serious complications.
authors.affiliation: Medizinische Klinik (Chefarzt Dr. B. Feinauer), Enzkreis-Kliniken, Mühlacker, Germany. guido.kleine@kliniken-ek.de
authors.forename: G
authors.initials: G
authors.lastname: Kleine
mesh_terms: D000328:Adult; D000748:Anemia, Macrocytic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014803:Vitamin B Complex / Q000097:blood / Q000627:therapeutic use
chemical_list: D014803:Vitamin B Complex; D005983:Glutens; D014805:Vitamin B 12