A 29-year old female patient presented by microcytic hypochromic anemia with parameters of iron deficiency. She was examined by diagnostic upper GIT endoscopy 12 months earlier and it showed GERD grade B. The patient continued to experience anemia and began to feel burning sensation behind the lower end of the sternum besides manifestations of reflux. Then she was re-examined by upper endoscopy and the lower esophagus showed diffuse ulcerations and marked tissue necrosis in a circumferential pattern, multiple biopsies were taken for histopathological examination (video) that revealed granulommatous inflammation of the esophagus.