scholarly journals Gastric Inflammatory Fibroid Polyp: A Rare Cause of Occult Upper Gastrointestinal Bleeding

2020 ◽  
Vol 8 ◽  
pp. 232470962093684
Author(s):  
Faisal Inayat ◽  
Asad Ur Rahman ◽  
Ahsan Wahab ◽  
Amir Riaz ◽  
Effa Zahid ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Modality ◽  
Deficiency Anemia ◽  
Resected Specimen ◽  
Fecal Occult Blood ◽  
Presenting Symptoms ◽  
Upper Gastrointestinal

Inflammatory fibroid polyps (IFPs) are rare mesenchymal lesions that can arise throughout the gastrointestinal tract. These tumors represent less than 0.1% of all gastric polypoid lesions and are frequently found incidentally on endoscopic evaluation. While presenting symptoms depend on the location of the tumor, gastric polyps commonly present with epigastric pain and early satiety. We hereby delineate the case of a middle-aged female who presented with chronic iron deficiency anemia and a positive fecal occult blood test. She underwent an upper endoscopy, which revealed an actively oozing umbilicated lesion in the gastric antrum. Endoscopic ultrasound divulged the submucosal origin of the lesion. It was subsequently excised using endoscopic mucosal resection. Pathologic examination of the resected specimen confirmed the diagnosis of gastric IFP. Furthermore, we conducted a systematic literature search of the MEDLINE database centered on gastric IFPs from January 2000 till March 2020. The data on patient demographics, clinical features, endoscopic findings, lesion site and size, and treatment approaches were collected and analyzed. This article illustrates the overarching need for clinicians to be vigilant of gastric IFPs presenting with initial clinical symptoms suggestive of occult upper gastrointestinal bleeding. Prompt diagnosis and management of gastric IFPs carry paramount importance to combat chronic unexplained iron deficiency anemia following occult bleeding in such patients. A concoction of endoscopy, biopsy, and immunohistochemical examination can be employed toward their prompt detection. Although gastric IFPs have conventionally been treated with surgery, endoscopic resection is now emerging as a safe and efficient therapeutic modality.

scholarly journals Gastric Siderosis and Ulceration from Intravenous Iron Supplementation Manifesting as Chronic Upper Gastrointestinal Bleeding: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Donald Ewing ◽  
Ava Brozovich ◽  
Ethan Burns ◽  
Gonzalo Acosta ◽  
Courtney Hatcher ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Gastrointestinal Bleeding ◽  
Iron Supplementation ◽  
Upper Gastrointestinal Bleeding ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Red Blood Cell Transfusions ◽  
Upper Gastrointestinal ◽  
Intravenous Iron Supplementation

Iron deficiency is the most common etiology of anemia worldwide and is often managed with varying methods of iron supplementation. Although rare, oral iron supplementation can perpetuate iron deficiency anemia by causing gastric ulceration and upper gastrointestinal bleeding in high-risk populations. However, this complication has not been previously described with intravenous iron supplementation. We present a case of a 63-year-old male with severe iron deficiency anemia on biweekly intravenous iron infusions and weekly packed red blood cell transfusions who presented with melena over several months. Upper endoscopy demonstrated a clean-based gastric body ulcer and nonbleeding gastric varices. Histology of the gastric ulcer was suggestive of iron-induced gastric mucosal injury. This case demonstrates that frequent utilization of intravenous iron and packed red blood cell transfusions may predispose certain patients to the development of iron-induced gastritis and ulceration.

Obscure gastrointestinal bleeding and iron-deficiency anemia—Where does capsule endoscopy fit?

2015 ◽  
Vol 17 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Emanuele Rondonotti ◽  
Anastasios Koulaouzidis ◽  
Paggi Silvia ◽  
Radaelli Franco ◽  
Marco Pennazio
Keyword(s):  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Deficiency Anemia

scholarly journals Sandifer Syndrome

2021 ◽  
Vol 3 (1) ◽  
pp. 30-32
Author(s):  
Juan Gomez
Keyword(s):  
Iron Deficiency ◽  
Gastroesophageal Reflux ◽  
Children And Adolescents ◽  
Hiatal Hernia ◽  
Iron Deficiency Anemia ◽  
Gastrointestinal Disorder ◽  
Deficiency Anemia ◽  
Neurological Manifestations ◽  
Upper Gastrointestinal

Sandifer syndrome, named after neurologist Paul Sandifer, was first reported by Marcel Kinsbourne in 1962, who noted an upper gastrointestinal disorder that occurs in children and adolescents with neurological manifestations. Sandifer syndrome is a neurobehavioral disorder that causes a series of paroxysmal dystonic movements in association with gastroesophageal reflux and, in some cases, with hiatal hernia. It is characterized by esophagitis, iron deficiency anemia, and is often mistaken for a seizure of epileptic origin.

scholarly journals A Rare Complication of Hyperplastic Gastric Polyp

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Suresh Kumar Nayudu ◽  
Masooma Niazi ◽  
Bhavna Balar ◽  
Kavitha Kumbum
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Outlet Obstruction ◽  
American Woman ◽  
Gastric Polyp ◽  
Deficiency Anemia ◽  
Surgical Specimen ◽  
Gastric Polyps ◽  
Therapeutic Benefits ◽  
Upper Gastrointestinal

Hyperplastic gastric polyps are incidentally diagnosed during upper gastrointestinal endoscopy. They are known to cause gastric outlet obstruction and chronic blood loss leading to iron deficiency anemia. However, hyperplastic gastric polyp presenting as acute severe upper gastrointestinal bleeding is very rare. To the best of our knowledge, there have been two cases of hyperplastic gastric polyps presenting as acute gastrointestinal bleeding in the medical literature. We present a case of a 56-year-old African American woman who was admitted to our hospital with symptomatic anemia and sepsis. The patient developed acute upper gastrointestinal bleeding during her hospital stay. She underwent emergent endoscopy, but bleeding could not be controlled. She underwent emergent laparotomy and wedge resection to control the bleeding. Biopsy of surgical specimen was reported as hyperplastic gastric polyp. We recommend that physicians should be aware of this rare serious complication of hyperplastic gastric polyps as endoscopic polypectomy has diagnostic and therapeutic benefits in preventing future complications including bleeding.

Pattern of Consultation Referrals for Cytopenia Evaluations to a Hematologist at An Academic Medical Center: The Expanding Role of a Consultant Hematologist

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4673-4673 ◽  
Author(s):  
Thein H Oo
Keyword(s):  
Primary Care ◽  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Primary Care Practice ◽  
Academic Medical Center ◽  
Deficiency Anemia ◽  
Care Practice ◽  
Low Grade ◽  
Hematologic Diseases

Abstract Purpose: It appears that many cytopenia consultation referrals to Hematology outpatient clinics turn out to have diseases related to primary care practice. The aim of this retrospective study is to see what proportion and what kind of cytopenia consultations in a Hematology clinic are due to disorders related to primary care practice. Methods: Retrospective chart review analysis of all outpatient referrals from July 2002 to June 2008 to a Hematologist at a tertiary university hospital was performed. Of those, only cytopenia consultations were analyzed. Cases were analyzed according to the presenting cytopenias and the final diagnoses. Results: There were a total of 942 outpatient consultation referrals during this period. 435 consultations were for cytopenia evaluations (46%). Of cytopenia evaluations, the demographics were as follows; male: female = 1: 1.5, age: <60: >60 = 1:1, Caucasian: non-non-Caucasian = 3:1. Distributions of cytopenia consultations were as follows: anemia (60%), thrombocytopenia (15%), leucopenia (10%), pancytopenia (6%), anemia and thrombocytopenia (4%), anemia and leucopenia (2.5%), leucopenia and thrombocytopenia (2.5%). Fortysix cases of cytopenia (11%) resolved on its own without any intervention. Final diagnoses of the rest were iron deficiency anemia 28% (65 cases of gastrointestinal bleeding, 47 cases of menorrhagia, 5 cases due to malabsorption, 5 cases of vegetarianism), myelodysplasia 8%, anemia of multifactorial origin (> more than 1 cause) 7%, anemia due to chronic renal failure only 6%, anemia of chronic disease 2%, drug-induced myelosuppression 6%, ITP 5%, ethnic leucopenia 4%, vitamin B12 deficiency 3%, thalassemia 3%, acute leukemia 2%, myeloma 2%, cirrhosis/hypersplenism 2%, sickle cell/hemoglobinopathy 1.5%, gestational thrombocytopenia 1.5%, viral hepatitis 1%, hereditary spherocytosis 1%, hemolytic anemia 1%, low grade lymphomas 1%, myelofibrosis 1%, non-immune chronic idiopathic neutropenia of adult 1%, immune leucopenia 0.5%, human immunodeficiency virus infection 0.5%, alcoholism 0.5%, paroxysmal nocturnal hemoglobinuria 0.25%. Primary hematologic diseases accounted for 34.25% while the remaining cases were diseases related to primary care practice. Conclusion: Cytopenia consultations accounted for 46% of all referrals. Anemia made up the majority of cytopenia consultations. Iron deficiency anemia due to gastrointestinal bleeding turned out to be the commonest final diagnosis while iron deficiency anemia due to menorrhagia was the second commonest diagnosis. Two-thirds of cytopenia consultations turned out to have diseases related to primary care medicine while primary hematologic diseases accounted for only one-third of the consultations. It appears hematologists are seeing more and more cases of cytopenias due to primary medical diseases (hematologic manifestations of medical diseases) rather than true primary hematologic disorders. Thus, the hematologist’s role as a consultant to primary care practitioners continues to expand.

scholarly journals Iron Deficiency Caused by Intestinal Iron Loss—Novel Candidate Genes for Severe Anemia

Genes ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1869
Author(s):  
Carolina Huettmann ◽  
Matthias Stelljes ◽  
Sugirthan Sivalingam ◽  
Manfred Fobker ◽  
Alexis Vrachimis ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Intravenous Iron ◽  
Iron Loss ◽  
Deficiency Anemia ◽  
Bone Marrow Biopsies ◽  
Current Form ◽  
Analysis Application ◽  
Iron Excretion

The adult human body contains about 4 g of iron. About 1–2 mg of iron is absorbed every day, and in healthy individuals, the same amount is excreted. We describe a patient who presents with severe iron deficiency anemia with hemoglobin levels below 6 g/dL and ferritin levels below 30 ng/mL. Although red blood cell concentrates and intravenous iron have been substituted every month for years, body iron stores remain depleted. Diagnostics have included several esophago-gastro-duodenoscopies, colonoscopies, MRI of the liver, repetitive bone marrow biopsies, psychological analysis, application of radioactive iron to determine intact erythropoiesis, and measurement of iron excretion in urine and feces. Typically, gastrointestinal bleeding is a major cause of iron loss. Surprisingly, intestinal iron excretion in stool in the patient was repetitively increased, without gastrointestinal bleeding. Furthermore, whole exome sequencing was performed in the patient and additional family members to identify potential causative genetic variants that may cause intestinal iron loss. Under different inheritance models, several rare mutations were identified, two of which (in CISD1 and KRI1) are likely to be functionally relevant. Intestinal iron loss in the current form has not yet been described and is, with high probability, the cause of the severe iron deficiency anemia in this patient.

scholarly journals Acute Pancreatitis and Upper Gastrointestinal Bleeding as Presenting Symptoms of a Duodenal Brunner’s Gland Hamartoma

2006 ◽  
Vol 20 (8) ◽  
pp. 541-542 ◽  
Author(s):  
Edy Stermer ◽  
Nizar Elias ◽  
Dean Keren ◽  
Tova Rainis ◽  
Omer Goldstein ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
English Literature ◽  
Presenting Symptoms ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Brunner’S Gland ◽  
Brunner's Gland ◽  
Brunner’S Gland Hamartoma ◽  
Upper Gastrointestinal

Brunner’s gland hamartomas are rare, benign small bowel tumours. There were fewer than 150 cases reported in the English literature until the end of the last century. These hamartomas may be discovered incidentally during an upper gastrointestinal tract endoscopy. Otherwise, they may be diagnosed in patients presenting with acute upper gastrointestinal bleeding, anemia or symptoms of intestinal obstruction. The case of a young woman admitted for acute upper gastrointestinal bleeding along with acute pancreatitis is presented. The investigation revealed a giant Brunner’s gland hamartoma in the second part of the duodenum. After total endoscopic resection of the tumour, the patient has remained completely asymptomatic for a follow-up period of seven months.

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