HYPERTROPHIC GASTROPATHY -ANEMIA. S. Ramalakshmi 1 , J. Lloyd 1 , R. Gregorio 1 , H. Dubner 1 ; 1 UPMC Shadyside Hospital, Pittsburgh, PA LEARNING OBJECTIVES: Hypertrophic gastropathy is a diverse disease characterized by giant mucosal hypertrophy of gastric rugae. The disease is usually confined to gastric body and fundus and can manifest with hypoalbuminemia. We present a case of an extensive hypertrophic gastropathy involving the antrum and body of the stomach associated with iron deficiency anemia. CASE INFORMATION: A 41year-old male patient during a routine physical, with symptoms of fatigue was diagnosed with iron deficiency anemia. Physical exam was unremarkable with guiac negative stools. Hemoglobin 6.0, Ferritin 1, Protein 4 and Albumin .9. Work-up of anemia included endoscopy, which showed diffuse nodularity of the body and a nodular mass in the antrum, which obscured pylorus and extended into second portion of the duodenum. Biopsies of stomach and duodenum were inconclusive. Upper GI series confirmed endoscopic findings. Due to the extensive involvement of the lesion as well as uncertainty of the diagnosis, gastrotomy was done. Large polypoid lesions were seen in the gastric antrum prolapsing into the duodenum and were excised. The mucosal surface of the duodenum was normal. Pathology was consistent with hypertrophic gastropathy. Stains and serum antibodies were negative for H. pylori. Patient was treated with acid suppressive therapy and iron supplementation. On follow-up patient was free of symptoms with Albumin 3.7 and Hemoglobin 12.2. DISCUSSION: This case is a relatively new variant of the already known hypertrophic gastropathy, in regards to its site and clinical presentation.