Abstract:
Vitamin B12 (cyanocobalamin) deficiency can lead to ineffective erythropoiesis, intramedullary hemolysis, and, in severe cases, neurologic deficits. Some of those findings are also features of thrombotic microangiopathies, specifically thrombotic thrombocytopenic purpura (TTP), and the distinction between both entities could sometimes be challenging. While the treatment of the former consists of enteral or parenteral repletion, the treatment of TTP is more complex and time-sensitive. For that reason, refining diagnostic strategies is crucial to avoid misdiagnosis and unnecessary interventions. Here is an example of a potential life-threatening hemolysis caused by vitamin B12 deficiency with acute onset neurologic symptoms, which resolved with B12 repletion.
摘要:
维生素B12(氰钴胺)缺乏可导致无效的红细胞生成,髓内溶血,and,在严重的情况下,神经缺陷.其中一些发现也是血栓性微血管病变的特征,特别是血栓性血小板减少性紫癜(TTP),两个实体之间的区别有时可能具有挑战性。虽然前者的治疗包括肠内或肠胃外补充,TTP的治疗更为复杂和时间敏感。出于这个原因,完善的诊断策略对于避免误诊和不必要的干预至关重要.这是一个由维生素B12缺乏引起的潜在危及生命的溶血的例子,伴有急性发作的神经系统症状,用B12补足解决。