Abstract
A 66-year-old female presented with fatigue, edema and jaundice. She had been diagnosed with Graves' disease at the age of 29 years but stopped going to the hospital for follow-up visits. Blood examination revealed pancytopenia and macrocytic anemia, and she was diagnosed with pernicious anemia due to low vitamin B12 level. Furthermore, she exhibited a high gastrin level, was positive for intrinsic factor antibodies, and showed atrophic changes predominantly in the fundic gland area of the stomach ; therefore, autoimmune gastritis was deemed to be the underlying cause. Symptoms were rapidly alleviated with vitamin B12 supplements. She was considered to have type 3B autoimmune polyendocrine syndrome on long-term follow-up. Among patients with autoimmune gastritis, there are high rates of gastric cancer and carcinoid complications. Therefore, in patients with autoimmune thyroid disease, care should be taken during endoscopic examination to observe for the presence of type A gastritis.
