Prueksaritanond Suartcha, Barbaryan Aram, Mirrakhimov Aibek E, Liana Palacci, Ali Alaa M, Gilman Alan D
Saint Joseph Hospital, Department of Internal Medicine, University of Illinois at Chicago, 2900 N., Lake Shore, Chicago, IL 60657, USA.
Case Rep Hematol. 2013;2013:708489. doi: 10.1155/2013/708489. Epub 2013 Sep 5.
A 52-year-old male with no significant past medical history reports increasing generalized fatigue and weakness for the past 2 weeks. Physical examination reveals jaundice and pallor without organomegaly or lymphadenopathy. His hemoglobin was 5.9 g/dL with a mean corpuscular volume of 87.1 fL and elevated red blood cell distribution width of 30.7%. His liver function test was normal except for elevated total bilirubin of 3.7 mg/dL. Serum LDH was 701 IU/L, and serum haptoglobin was undetectable. Further investigation revealed serum vitamin B12 of <30 pg/mL with elevated methylmalonic acid and homocysteine level. In addition, serum ferritin and transferrin saturation were low. The patient was diagnosed with hemolytic anemia secondary to vitamin B12 deficiency with concomitant iron deficiency anemia.
一名52岁男性，既往无重大病史，自述在过去2周内全身疲劳和虚弱感加重。体格检查发现黄疸和面色苍白，无脏器肿大或淋巴结病。他的血红蛋白为5.9g/dL，平均红细胞体积为87.1fL，红细胞分布宽度升高至30.7%。除总胆红素升高至3.7mg/dL外，其肝功能检查正常。血清乳酸脱氢酶为701IU/L，血清触珠蛋白检测不到。进一步检查发现血清维生素B12<30pg/mL，甲基丙二酸和同型半胱氨酸水平升高。此外，血清铁蛋白和转铁蛋白饱和度较低。该患者被诊断为维生素B12缺乏继发溶血性贫血，并伴有缺铁性贫血。
