A rare cause of dyspeptic symptoms and anaemia in a young man & Answer

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.\n\nIn 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. …