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[Atrophic gastritis presenting with pulmonary embolism]
M A Abdul-Ghani1, R Feldman, M Shai
1Dept. of Medicine C, Western Galilee Hospital, Naharia.
Harefuah
|May 9, 2001
Summary
Atrophic gastritis can cause severe vitamin B12 deficiency, leading to hyperhomocysteinemia and increased risk of blood clots. This case highlights the importance of considering B12 deficiency in unexplained hypercoagulability.
Area of Science:
- Gastroenterology
- Hematology
- Endocrinology
Background:
- Atrophic gastritis is an autoimmune condition causing gastric parietal cell destruction.
- This leads to intrinsic factor deficiency, impairing vitamin B12 absorption.
- Vitamin B12 deficiency can manifest as anemia, neurological deficits, and hyperhomocysteinemia.
Observation:
- A 51-year-old man presented with pulmonary embolism.
- He had atrophic gastritis and severe vitamin B12 deficiency.
- Anemia and neurological symptoms were notably absent initially.
Findings:
- The patient exhibited significant hyperhomocysteinemia due to vitamin B12 deficiency.
- Hyperhomocysteinemia is increasingly recognized as a risk factor for thrombo-embolic disease.
- Pulmonary embolism occurred in the absence of typical B12 deficiency signs.
Implications:
- Vitamin B12 deficiency should be considered in the workup of hypercoagulable states.
- Early detection and management of B12 deficiency may prevent thrombo-embolic events.
- This case underscores the link between autoimmune gastropathy, metabolic disturbances, and thrombotic risk.