A rare case of pediatric iron deficiency anemia: Gastric hamartomatous polyp

Iron deficiency anemia (IDA) is the most common hematologic disorder in children and may result from chronic blood loss. Gastrointestinal (GI) sources should be considered, even in the absence of prominent symptoms. We report a previously healthy 6‐year‐old girl with 2 years of fatigue and intermittent abdominal pain found to have severe microcytic anemia (hemoglobin 4.7 g/dL) and iron deficiency. A heme‐positive stool suggested occult GI bleeding. Endoscopy demonstrated a large pedunculated polyp in the gastric body, confirmed on pathology as a hamartomatous gastric polyp with intestinal metaplasia, with no dysplasia. Colonoscopy and capsule endoscopy were normal, and genetic testing for hereditary polyposis syndromes, including STK11 mutation, was negative. Hemoglobin levels improved with iron supplementation. This case highlights a rare cause of severe pediatric IDA and underscores the importance of considering structural GI lesions and endoscopic evaluation in unexplained pediatric IDA.