[Asymptomatic gastric phytobezoar and anaemia due to iron deficiency revealing an autoimmune gastritis].

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This observation recalls that gastric phytobezoar should lead to a search for an underlying disease and that a iron deficiency can be associated and hide macrocytosis related to a vitamin B 12 deficiency .A 19 year -old woman consulted for asthenia . Microcyte anaemia associated with iron deficiency was diagnosed . Upper digestive endoscopy revealed severe , totally asymptomatic phytobezoar . Biological investigations revealed a vitamin B 12 deficiency , high serum gastrin level and strong positivity for gastric antiparietal anti-cell antibodies , suggestive of an autoimmune gastritis . Total immunoglobulin A deficiency was also noted .Autoimmune gastritis is responsible for megaloblastic anaemia (vitamin B 12 deficiency ) but can also provoke microcytic (iron -deficiency ) anaemia due to insufficient absorption of the latter and related to gastric achlorhydria . Phytobezoar might also be related to achlorhydria and /or gastroparesia associated with autoimmune gastritis . Hence , autoimmune gastritis should be searched for when confronted with unexplained gastric bezoar or iron -deficiency anaemia .