PMC9669597_01
Esophagogastroduodenoscopy showing atrophic gastritis with nodular mucosa and multiple non-bleeding ulcerations.
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F1
Given concern for a new or worsening upper GI bleed, an urgent esophagogastroduodenoscopy (EGD) was performed which revealed atrophic gastritis with nodular and thickened mucosa, and multiple non-bleeding ulcerations in the gastric body, antrum, and prepyloric regions (Figure 1).
Gastric biopsy confirming the diagnosis of iron pill gastritis. Gastric lesions were biopsied and stained with H&E, showing inflammation with pits of brown pigment (yellow arrows) consistent with iron gastropathy. Tissues were also stained via Prussian blue, confirming the presence of iron crystals (yellow arrows) in the gastric mucosa.
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F2
A hemostatic clip was placed in the second portion of the duodenum, and ulcerations were biopsied, showing inflammation with pits of brown pigment consistent with iron gastropathy (Figure 2). Biopsies showed no evidence of intestinal metaplasia or lymphoma, stained negative for H. pylori, and positive for iron crystals via Prussian blue staining (Figure 2).