A case of type A gastritis complicated by pernicious anemia and early gastric cancer

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  • A型胃炎に悪性貧血, 早期胃癌を合併した1例

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An 86-year-old man presented to our hospital with a 1-week history of undifferentiated dizziness. He was hospitalized for intensive evaluation as hematological tests showed severe anemia (Hb5.3g/dL), along with giant erythroblastic anemia. Based on the results of hematological analysis and esophagogastroduodenoscopy findings, we diagnosed the patient with pernicious anemia caused by type A gastritis. His pernicious anemia was treated by intramuscular injections of vitamin B12, which improved the anemia. Esophagogastroduodenoscopy also showed a 25-mm sized polypoid lesion in the upper-posterior wall of the stomach. Therefore, he underwent further evaluation with esophagogastroduodenoscopy, endoscopic ultrasonography, contrast-enhanced CT, and biopsy. Based on the results, we diagnosed the patient with early gastric well-differentiated tubular adenocarcinoma for which a curative endoscopic submucosal dissection (ESD) was performed.Furthermore, another 10-mm sized elevated-type lesion with no continuity was observed, which was also a well-differentiated tubular adenocarcinoma. As the number of patients with Helicobacter pylori infection is decreasing, physicians need to be aware of type A gastritis.

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