Keywords
anemia
microangiopathy
How to Cite
Abstract
Vitamin B12 is a cofactor involved in DNA synthesis, red blood cell production and essential for neurologic functions. Its deficiency can lead to varied manifestations. Thrombotic pseudomicroangiopathy is characterized by microangiopathic hemolytic anemia and thrombocytopenia associated with dysmorphic red blood cells secondary to severe vitamin B12 deficiency, with an approximate incidence of 2.5%. It is often confused with thrombotic thrombocytopenic purpura and treated as such. Replacement with cyanocobalamin leads to immediate improvement of symptoms without the need of other treatments. We describe three cases of patients hospitalized in a general hospital in Panama City, Republic of Panama. Two males and one female with no pathological history presenting with anemic syndrome, microangiopathic hemolytic anemia and severe vitamin B12 deficiency. Clinical improvement was observed following parenteral cyanocobalamin replacement.
References
Azzini E et al. A Brief Review on Vitamin B12 Deficiency Looking at Some Case Study Reports in Adults. Int J Mol Sci. 2021;22(18):9694. Disponible en: https://doi.org/10.3390/ijms22189694.
Fahmawi Y et al. Vitamin B12 Deficiency presenting as pseudothrombotic microangiopathy: a case report and literature review. Clin Pharmacol: Advances and Applications. 2019;11:127-31. Disponible en: Https://doi.org/10.2147/CPAA.S207258.
Sabry W et al. Vitamin B12 Deficiency and Metabolism-Mediated Thrombotic Microangiopathy (MMTMA). Transfus Apher Sci. 2020;59(1):102717. Doi: 10.1016/ j.transci.2019.102717.
Wathieu H, Bateman KM. A Case of Pseudothrombotic Microangiopathy Associated with Pernicious Anemia. J GEN INTERN MED. 2021;36:1775–7. Disponible en: https://doi.org/10.1007/s11606-020-06588-2.
Stabler S. Vitamin B12 Deficiency. N Engl J Med. 2013;368(2):149–60. Disponible en: https://doi.org/10.1056/NEJMcp1113996
Farrelly SJ, O'Connor KA. Hypersegmented neutrophils and oval macrocytes in the setting of B12 deficiency and pancytopaenia. BMJ Case Rep. 2017. Doi: 10.1136/bcr-2016-218508.
Htut TW et al. “Pernicious Anemia: Pathophysiology and Diagnostic Difficulties.” Journal of Evidence-Based Medicine. 2021;14(2):161–9. Disponible en: https://doi.org/10.1111/jebm.12435
Kadhim G et al. “Vitamin B12 Deficiency in Helicobacter Pylori Infected Patients.” OALib. 2018;5(3):1–4. Disponible en: https://doi.org/10.4236/oalib.1104172.
Gowdappa H, Mahesh M, Murthy K, et al. Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord. BMJ Case Rep. 2013. Doi: 10.1136/bcr-2013-200380.
Tun A, Myint Z, Rojas Hernandez C et al. ´´Vitamin B12 Deficiency-Related Pseudo-Thrombotic Microangiopathy Might be Misdiagnosed and Treated with Plasma Product Therapy: Review of the Literature and Analysis of the Reported Cases´´. Blood. 2017;130(1): 5576. Disponible en: https://doi.org/10.1182/blood.V130.Suppl_1.5576.5576.
Ankar, Alex, and Anil Kumar. “Vitamin B12 Deficiency.” StatPearls, StatPearls Publishing, 2024. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK441923/.
Gowdappa H, Mahesh M, Murthy K, et al. Helicobacter pylori associated vitamin B12 deficiency, pernicious anaemia and subacute combined degeneration of the spinal cord. BMJ Case
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