Randhawa Jaskirat, Ondrejka Sarah L, Setrakian Sebouh, Taylor Harris
Fairview/Cleveland Clinic, Cleveland, Ohio, USA.
BMJ Case Rep. 2013 Jul 8;2013:bcr2013010200. doi: 10.1136/bcr-2013-010200.
Vitamin B12 deficiency is a well recognised cause of macrocytic anaemia and bone marrow failure. Bone marrow aspiration/biopsy is infrequently indicated for the diagnosis in this setting. However, if a bone marrow aspiration/biopsy is performed, it is important to recognise that it may show dysplastic changes mimicking myelodysplastic syndrome (MDS) or acute leukaemia. We report a case of a 66-year-old non-vegetarian man presenting with generalised weakness for 1 month and misdiagnosed on bone marrow biopsy as MDS. However, laboratory investigations revealed severe deficiency of vitamin B12. Four weeks after starting vitamin B12 replacement the patient's complete blood counts reverted to normal.
维生素B12缺乏是大细胞性贫血和骨髓衰竭的一个公认病因。在这种情况下，骨髓穿刺/活检很少用于诊断。然而，如果进行了骨髓穿刺/活检，重要的是要认识到其可能显示出类似骨髓增生异常综合征（MDS）或急性白血病的发育异常改变。我们报告一例66岁非素食男性病例，该患者出现全身无力1个月，骨髓活检误诊为MDS。然而，实验室检查显示维生素B12严重缺乏。开始补充维生素B12四周后，患者的全血细胞计数恢复正常。
