Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://jmc.elmerpub.com

Case Report

Volume 16, Number 10, October 2025, pages 401-405

A Rare Co-Occurrence of Gastric Heterotopia and Autonomic Nervous System Dysfunction: An Attempt to Explain If There Is a Need to Explore Possible Syndromic Link

Figures

Figure 1.
Figure 1. Colonoscopy showing gastric heterotopia identified in the rectum with traditional white light endoscopy (left) as well as narrow band imaging (right). The heterotopia is a 15-mm well circumscribed erythematous patch.
Figure 2.
Figure 2. Computed tomography imaging did not reveal any abnormality. There was no evidence of malignancy.
Figure 3.
Figure 3. Summary of steps in the diagnosis.

Table

Table 1. Blood Test and Corresponding Result at the Time of Initial Presentation to GP
 
Blood testResultNormal reference range
ESR: erythrocyte sedimentation rate; GP: general practitioner; MCV: mean corpuscular volume; RBC: red blood cell; TSH: thyroid-stimulating hormone; WBC: white blood cell.
Hemoglobin139.0 g/L130 - 170 g/L
WBC3.2 ×109/L3.7 - 11.1 × 109/L
Platelet209 × 109/L150 - 450 × 109/L
RBC4.50 × 1012/L4.6 - 6.2 × 1012/L
Hematocrit0.397 L/L0.4 - 0.5 L/L
MCV88.2 fL80 - 101 fL
Mean cell hemoglobin level30.9 pg27 - 32 pg
Mean cell hemoglobin concentration350 g/L290 - 360 g/L
Neutrophil1.9 × 109/L1.7 - 7.5 × 109/L
Lymphocyte0.7 × 109/L0.9 - 3.2 × 109/L
Monocyte0.4 × 109/L0.2 - 1 × 109/L
Eosinophil0.2 × 109/L0 - 0.5 × 109/L
Basophil0.0 × 109/L0 - 0.1 × 109/L
ESR6 mm/h1 - 12 mm/h
Vitamin B12 level195 ng/L144 - 915 ng/L
Folate18.8 µg/L3.1 - 19.9 µg/L
Ferritin64 ng/mL23.9 - 333.2 ng/mL
TSH0.662 mIU/L0.34 - 5.6 mIU/L