Autoimmune gastritis in a male adolescent with cerebellar involvement: A case report

INTRODUCTION: Autoimmune gastritis is an immune mediated disorder characterized as anti-intrinsic factor and anti-parietal cell autoantibodies directed against intrinsic factor and parietal cells of the stomach respectively, leading to vitamin B12 deficiency. When the disease remains undiagnosed and untreated, it may lead to neurological complications and even fatal anemia. CASE STUDY: We exemplify a non-vegetarian male adolescent case with the neurological symptoms such as bilateral leg weakness, unsteady gait, slurred speech, vertigo, slowed movement, lethargy, and impaired joint sensation. None of his family members had such illness. His hemoglobin was normal with serum vitamin B12 level 105 pg/mL and anti-intrinsic factor antibody titer positive. A presumed diagnosis of cobalamin deficiency with involvement of the cerebellum, dorsal column and peripheral nerves was made. His symptoms recovered gradually and later completely (after 6 months) after the intramuscular vitamin B12 therapy. CLINICAL DISCUSSION: The indexed rare adolescent case had auto immune gastritis showing neurological manifestation with more pronounced cerebellar features and vitamin B12 deficiency under the non-vegetarian diet consumption. Previous studies had reflected auto immune among adolescents but contrasted some of the clinical features. CONCLUSION: For the prompt and precise diagnosis of the autoimmune gastritis and to prevent further complications, some of the rare conditions such as deficiency with a non-vegetarian diet, neurological manifestation including cerebellar involvement without anemia should also be considered along with other relevant symptoms. The heightened awareness for timely surveillance and treatment will contribute in reduction of such unusual cases.