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A rare cause of dyspeptic symptoms and anaemia in a young man
  1. Hareem Rehman1,
  2. Shahab Abid1,
  3. Naila Kayani2,
  4. Ali Haroon1
  1. 1 Medicine, Aga Khan University, Karachi, Sindh, Pakistan
  2. 2 Pathology, Aga Khan University, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Shahab Abid, Medicine, Aga Khan University, Karachi 3500, Pakistan; shahab.abid{at}

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A 33-year-old male patient presented to our gastroenterology clinic, in January 2020, with complains of early satiety, regurgitation, heartburn and weakness for the past several months. He denied any complains of nausea, vomiting or weight loss. His past medical history was significant for a Heineke-Mikulicz pyloroplasty secondary to gastric outlet obstruction in 2004 at the age of 17 years, after which he remained relatively asymptomatic for 10 years. He had an unremarkable family history for autoimmune disease or gastric cancer.

In 2014, he developed anorexia, weight loss, weakness and numbness in the fingers, and was diagnosed with megaloblastic anaemia secondary to vitamin B12 deficiency. An endoscopy performed at that time revealed moderate-to-severe gastritis (figure 1A), and biopsy revealed atrophic gastritis. …

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  • Contributors HR prepared the manuscript, did literature search and was part of the management team for this patient. SA is the corresponding author and supervised the manuscript preparation, prepared endoscopy images and revised the final draft. NK identified the pathology, prepared histopathology images and reviewed the manuscript. AH was part of the management team of the patient, and helped in the preparation of endoscopy images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.