PMC7245653_01
Peripheral smear with hypersegmented neutrophils.
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fig1
PNH was a diagnosis on the differential. Peripheral smear was notable for hypersegmented neutrophils, macrocytic normochromic anemia, thrombocytopenia, and lacked schistocytes (Figure 1).
Gastric biopsy showing lymphoplasmacytic cells in the lamina propria of gastric tissue. No neutrophilic activity is identified. Atrophy was noted without dysplastic alterations.
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fig2
Biopsies were taken of the mucosa that suggested chronic atrophic gastritis with histologic and immunohistochemical findings consistent with pernicious anemia without evidence of Helicobacter pylori (Figure 2).