Rare co-occurrence of probable pernicious anemia and autoimmune hepatitis in a 55-year-old male patient: A case report

This is a case of probable pernicious anemia in the setting of autoimmune hepatitis. A 55-year-old male patient presented to the Emergency Room at Dr. Ruth K.M. Pfau Civil Hospital, Karachi with complaints of diarrhea and fever and was subsequently transferred to the medicine ward. The patient also had signs of unexplained anemia. We performed laboratory tests and were able to rule out the common causes of liver pathology, including viral hepatitis. For blood, the values showed decreased hemoglobin levels and an elevated Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) (114 fL), indicating macrocytosis. Finally, we were able to conclude autoimmune pathology after the results of antibody testing demonstrated positive lab values for anti-smooth muscle antibodies, antinuclear antibodies, and anti-gastric parietal cell antibodies. The patient had developed pernicious anemia in the setting of autoimmune hepatitis, which is an extremely rare case and documented instances are scarce in the available literature regarding such cases.