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

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 haptoglo...

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Main Authors: G. F. Cittolin-Santos, S. Khalil, J. K. Bakos, K. Baker
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2020/8697493
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author G. F. Cittolin-Santos
S. Khalil
J. K. Bakos
K. Baker
author_facet G. F. Cittolin-Santos
S. Khalil
J. K. Bakos
K. Baker
author_sort G. F. Cittolin-Santos
collection DOAJ
description 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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series Case Reports in Hematology
spelling doaj-art-c8de1cb97e894f949db3c379e6f770632025-08-20T03:24:08ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/86974938697493Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic AnemiaG. F. Cittolin-Santos0S. Khalil1J. K. Bakos2K. Baker3Medical University of South Carolina, Department of Internal Medicine, Charleston, SC, USAMedical University of South Carolina, Department of Internal Medicine, Charleston, SC, USAMedical University of South Carolina, Department of Internal Medicine, Charleston, SC, USAMedical University of South Carolina, Department of Internal Medicine, Charleston, SC, USAA 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.http://dx.doi.org/10.1155/2020/8697493
spellingShingle G. F. Cittolin-Santos
S. Khalil
J. K. Bakos
K. Baker
Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
Case Reports in Hematology
title Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
title_full Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
title_fullStr Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
title_full_unstemmed Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
title_short Chronic Atrophic Gastritis with Negative Intrinsic Factor and Parietal Cell Antibody Presenting as a Severe Hemolytic Anemia
title_sort chronic atrophic gastritis with negative intrinsic factor and parietal cell antibody presenting as a severe hemolytic anemia
url http://dx.doi.org/10.1155/2020/8697493
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