Jorge Avila^1,, Inés Reyes¹, Larissa Villacrés², Diego Rosado², Jhoanna Ramírez¹

We present the case of a 77-year-old female patient, who is derived from her primary care physician to our department with fatigue and laboratory exams that revealed hemoglobin 7.8 g / dl, leukocytes 6.3000/mm3, platelets 210000/mm3, total bilirubin 3.8 mg/dl, indirect bilirubin 2.09 mg/dL, LDH 936 U/I, Vitamin B12 <100, VCM 118 fl, folic acid > 24 ng/ml, total iron 215 mcg/dl, ferritin 187 ng/ml and antibodies against parietal cells, so pernicious anemia (PA) was diagnosed. She later received reposition treatment of vitamin b12 and was scheduled for endoscopic studies. Colonoscopy showed the presence of two diverticula in the sigmoid colon; while her upper endoscopy revealed a 2.5 cm stomach polyp. A biopsy was performed and it resulted positive for synaptophysin, with a Ki67 index <1%, so gastric neuroendocrine tumor (NET) type I was diagnosed, and it was subsequently resected by partial gastrectomy. Patients with a diagnosis of pernicious anemia have a higher risk of developing NETs in the gastrointestinal (GI) system, however, endoscopic screening is not performed in all patients with this disease. The purpose of this report is to encourage medical professionals to perform complete studies of the GI system to all patients that are diagnosed with PA.

pernicious anemia, neuroendocrine tumor, gastric carcinoid