Reply to V. Maunoury et al.

We wish to thank Drs. Maunoury and Bulois for their insightful comments. We are in complete agreement and do indeed recommend that, in addition to duodenal biopsies being obtained at the time of esophagogastroduodenoscopy (EGD), gastric biopsies are taken as well. Gastric biopsies should be obtained from both the gastric antrum and body. Histopathological evaluation of gastric biopsies may well provide important additional information, including microscopic evidence for atrophic gastritis and Helicobacter pylori infection, as to the cause of the iron deficiency anemia. Additional serological testing, including that for fasting gastrin levels, anti-parietal cell antibodies, and celiac disease, may also be carried out on a case-by-case basis at the discretion of the treating physician.

Ian M. Gralnek, MD, MSHS

Competing interests: None