{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:10:21Z","timestamp":1785413421146,"version":"3.56.0"},"reference-count":10,"publisher":"Department of Medicine, Warren Alpert Medical School at Brown University","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>A 29-year-old woman presented with abdominal pain, nausea, vomiting, and non-bloody diarrhea and was found to have profound microcytic iron deficiency anemia (hemoglobin 4.8 g\/dL). Endoscopy and colonoscopy revealed numerous colonic, rectal, and gastric polyps. CT enterography showed multiple large jejunal polyps and a short-segment intussusception without obstruction. Histopathology confirmed hamartomatous polyps, and genetic testing identified a heterozygous pathogenic Serine\/threonine kinase 11 (STK11\/LKB1) variant, confirming Peutz\u2013Jeghers syndrome. As a Jehovah\u2019s Witness, she declined allogenic blood products. A comprehensive transfusion-free anemia management protocol, including intravenous iron dextran, erythropoiesis-stimulating agents, vitamin supplementation, and minimization of iatrogenic blood loss, resulted in hemoglobin to improve to 10.9 g\/dL at 4 weeks and 14.0 g\/dL at 4 months, enabling elective robotic-assisted jejunal polypectomy. This case highlights Peutz\u2013Jeghers syndrome as an uncommon cause of severe iron deficiency anemia and illustrates a multidisciplinary, ethically sensitive, transfusion-sparing approach to managing life-threatening anemia in a Jehovah\u2019s Witness patient.<\/jats:p>","DOI":"10.56305\/001c.158649","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:51:30Z","timestamp":1775062290000},"source":"Crossref","is-referenced-by-count":0,"title":["Severe Iron Deficiency Anemia in a Jehovah\u2019s Witness diagnosed with Peutz-Jeghers Syndrome"],"prefix":"10.56305","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4850-8849","authenticated-orcid":false,"given":"Virali","family":"Gulla","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritwik","family":"Dey","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yagnapriya","family":"Chirrareddy","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bustamante","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Robles","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Division of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhizith","family":"Deoker","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1177\/2050640619874525","article-title":"Small bowel polyp resection using device-assisted enteroscopy in Peutz-Jeghers Syndrome: Results of a specialised tertiary care centre","volume":"8","author":"G. 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