TY - JOUR T1 - An unexpected cause of iron deficiency JF - Gut JO - Gut SP - 1434 LP - 1579 DO - 10.1136/gutjnl-2020-321830 VL - 70 IS - 8 AU - Thomas Edward Conley AU - Timothy Andrews AU - Arvind Arumainathan AU - Paul O'Toole AU - Philip J Smith AU - Sreedhar Subramanian Y1 - 2021/08/01 UR - http://gut.bmj.com/content/70/8/1434.abstract N2 - A 70-year-old man presented with progressive weight loss and intermittent lower abdominal pain. Bowel habit was unchanged, there was no overt blood loss and there were no constitutional symptoms. His medical history included vascular Parkinson’s, hypertension, osteoarthritis, type 2 diabetes mellitus and colonic polyps. His medications included pantoprazole and clopidogrel.On physical examination, his abdominal and digital rectal examinations were unremarkable. Laboratory tests revealed normocytic (mean cell volume 84.1 fL) hypoferritinaemia (15 μg/L) with low haemoglobin (123 g/L). Coeliac serology, other haematinics and immunoglobulin profile were normal. Urinalysis excluded haematuria.Gastroscopy and duodenal biopsies were normal and urease test was negative for Helicobacter pylori. CT colonography identified a 22 mm proximal sigmoid lesion with a depressed centre concerning for extension beyond … ER -