Autoimmune gastritis concomitant with gastric adenoma and subacute combined degeneration of the spinal cord

BMJ Case Rep. 2021 May 11;14(5):e242836. doi: 10.1136/bcr-2021-242836.

Abstract

A 62-year-old woman was referred to our department for further investigation of anaemia. Blood test showed macrocytic anaemia. Oesophagogastroduodenoscopy (OGD) revealed proximal-predominant gastric atrophy and flat elevated lesion in the gastric body. Several days after OGD, she complained of gait disturbance and was diagnosed with subacute combined degeneration of the spinal cord. Furthermore, laboratory tests showed positive for both anti-parietal cell and anti-intrinsic factor antibodies, as well as increased serum gastrin level and decreased pepsinogen I level, which confirmed the diagnosis of autoimmune gastritis (AIG). Anaemia and neurological symptoms were improved after vitamin B12 supplementation. Subsequently, the patient underwent gastric endoscopic submucosal dissection; histopathological examination revealed gastric adenoma. AIG can cause gastric neoplasms and vitamin B12 deficiency, with the latter resulting in pernicious anaemia and neurological disorders. These diseases are treatable but potentially life-threatening. This case highlights the importance of early diagnosis of AIG and proper management of its comorbidities.

Keywords: endoscopy; spinal cord; stomach and duodenum; vitamins and supplements.

Publication types

  • Case Reports

MeSH terms

  • Adenoma* / pathology
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Diseases* / pathology
  • Female
  • Gastritis* / complications
  • Gastritis* / diagnosis
  • Gastritis* / pathology
  • Humans
  • Middle Aged
  • Spinal Cord / pathology
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / surgery
  • Subacute Combined Degeneration*
  • Vitamin B 12 Deficiency* / complications
  • Vitamin B 12 Deficiency* / diagnosis
  • Vitamin B 12 Deficiency* / drug therapy