eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-06-25 9 10 516 518 10.12691/ajmcr-9-10-10 AJMCR202191010 article Shawn Philip shawn.philip316@gmail.com 1 Luz Sullivan 2 Nour Parsa 3 Albany Medical Center, Department of Internal Medicine, Albany, NY. USA Albany Medical Center, Department of Pathology, Albany, NY. USA Albany Medical Center, Department of Gastroenterology, Albany, NY. USA Autoimmune metaplastic atrophic gastritis is an important pathological finding associated with neoplasia and pernicious anemia. Defined guidelines on surveillance endoscopy for this diagnosis are lacking. We present a rare case of a patient with a known history of pernicious anemia that presented with blood-tinged sputum. The patient underwent endoscopic evaluation with random gastric biopsies that showed a two-month progression from diffuse inflammation to intestinal metaplasia in the background of autoimmune metaplastic atrophic gastritis (AMAG) on surveillance endoscopy. AMAG is an important finding that deserves close endoscopic surveillance as complications can include autoimmune conditions, pernicious anemia,gastric carcinoid, and gastric adenocarcinoma. http://pubs.sciepub.com/ajmcr/9/10/10/ajmcr-9-10-10.pdf gastritis pernicious anemia autoimmune metaplastic atrophic gastritis