Severe Vitamin B12 Deficiency Mimicking Microangiopathic Hemolytic Anemia
| Autor: | Ramzi Hassouneh, Olivia Lee, Steve Shen, Patrick Fadden, Rachel A. Hart, Logan P. Rhea |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Microangiopathic hemolytic anemia
Hemolytic anemia Pseudo-thrombotic microangiopathy medicine.medical_specialty business.industry Anemia Microangiopathy Thrombotic thrombocytopenic purpura Case Report medicine.disease Intensive care unit Gastroenterology law.invention Vitamin B12 deficiency law hemic and lymphatic diseases Internal medicine medicine Vitamin B12 business pernicious anemia |
| Zdroj: | Journal of Hematology |
| ISSN: | 1927-1220 1927-1212 |
| DOI: | 10.14740/jh889 |
| Popis: | Most individuals with vitamin B12 deficiency present with anemia, fatigue, and neurologic disturbances such as paresthesia and loss of sensory function if chronic. However, in severe states, it may manifest as hemolytic anemia, thrombocytopenia, schistocytosis, elevated lactate dehydrogenase, and low reticulocyte production. This phenomenon is known as pseudo-thrombotic microangiopathy (TMA), and is most commonly due to pernicious anemia. The overlap in clinical presentation with primary TMA creates a challenge in the diagnosis and management of pseudo-TMA. Primary TMA, particularly thrombotic thrombocytopenic purpura, is emergently managed with plasma exchange and may require admission to an intensive care unit due to high risk of mortality. In contrast, pseudo-TMA does not respond to plasma exchange and instead is treated with vitamin B12 supplementation. Patients with this atypical presentation of B12 deficiency may receive unnecessary, costly, and potentially harmful therapy. We present the case of a patient with pseudo-TMA in the setting of pernicious anemia. J Hematol. 2021;10(4):202-205 doi: https://doi.org/10.14740/jh889 |
| Databáze: | OpenAIRE |
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