Lymphocytic gastritis (LG) is a chronic inflammatory process of poorly understood pathogenesis. We report the case of a 12-year-old premenstrual girl with refractory iron deficiency anemia in which the oral iron absorption challenge suggested iron malabsorption. Laboratory studies ruled out celiac disease and autoimmune gastritis, and carbon-13 urea breath test for Helicobacter pylori was also negative. Upper endoscopy with gastric body and antral mucosa biopsies revealed a LG with focal intestinal metaplasia and H. pylori infection. H. pylori eradication was undertaken with success and 3 months later her hematologic parameters normalized. Histologic reevaluation showed disappearance of LG. This case shows that investigation of malabsorption disease in the presence of refractory iron deficiency anemia can lead to the diagnosis of important gastric diseases, even in the absence of gastrointestinal symptoms. This nonceliac child was diagnosed with a severe histopathologic pattern of LG, with potential risk of malignant transformation, which was completely reverted with adequate H. pylori eradication treatment.
*Department of Pediatrics, Centro Hospitalar do Alto Ave
Departments of †Pediatric Hematology
§Pediatric Gastroenterology, Centro Hospitalar do Porto, Porto, Portugal
The authors declare no conflict of interest.
Reprints: Marta F.F. Santalha, Jr, MD, Rua Lúcia Lousada, no. 319, 4 DT, 4620-030 Lousada, Portugal (e-mail: firstname.lastname@example.org).
Received July 5, 2012
Accepted January 8, 2013