An unusual cause of anemia : familial hyperplastic gastric polyposis

Familial hyperplastic gastric polyposis is a very rare entity, and up to now, only few cases have been reported (1, 2). A 57-year-old man was admitted with complaints of dyspepsia for a long time. He was taking proton pump inhibitors for about 30 years. His family history revealed gastric polyposis in his father and brother; however, there was no history of gastrointestinal cancer. Physical examination was unremarkable. On admission, laboratory studies were normal other than a hemoglobin level of 10.2 g/dL. Upper endoscopic examination revealed dozens of polyps (3-12 mm in diameter) through out the fundus and corpus of the stomach (Fig. 1). Larger polyps were removed by cutting with snare. Histological examination of the materials was compatible with hyperplastic polyps (Fig. 2). Helicobacter Pylori was positive at antrum biopsy. Since past medical history of our patient revealed standard treatment against Helicobacter Pylori for several times, he was prescribed sequential therapy for eradication. The patient refused to perform colonoscopic examination and further genetic analysis.