维生素B12缺乏症酷似急性白血病。
Vitamin B12 deficiency mimicking acute leukemia.
作者信息
Konda Manojna, Godbole Abhijit, Pandey Soumya, Sasapu Appalanaidu
机构信息
Department of Internal Medicine, University of Arkansas for Medical SciencesLittle RockArkansas.
Department of Hematology and Oncology, University of Arkansas for Medical SciencesLittle RockArkansas.
出版信息
Proc (Bayl Univ Med Cent). 2019 Jul 30;32(4):589-592. doi: 10.1080/08998280.2019.1641045. eCollection 2019 Oct.
Vitamin B12 deficiency can cause extensive hematologic alterations such as pancytopenia, macrocytosis, hypersegmentation of neutrophils, and hypercellular bone marrow with blastic differentiation. These dysplastic changes can sometimes be so profound that they mimic myelodysplastic syndromes or even acute leukemia, leading to extensive workup and aggressive treatment measures. We present a patient who was referred to our tertiary care medical center for treatment of suspected acute myeloid leukemia on the basis of peripheral smear and bone marrow biopsy findings, and induction chemotherapy was considered. However, the patient was found to have vitamin B12 deficiency, with improvement in pancytopenia and blastic changes with parenteral vitamin B12 supplementation. This highlights the importance of recognizing that dysplastic changes in patients with vitamin B12 deficiency could be misleading.
维生素B12缺乏可导致广泛的血液学改变，如全血细胞减少、大细胞性贫血、中性粒细胞核分叶过多以及骨髓细胞增多伴原始细胞分化。这些发育异常的变化有时可能非常严重，以至于酷似骨髓增生异常综合征甚至急性白血病，从而导致广泛的检查和积极的治疗措施。我们报告一名患者，根据外周血涂片和骨髓活检结果，因疑似急性髓系白血病被转诊至我们的三级医疗中心接受治疗，并考虑进行诱导化疗。然而，发现该患者存在维生素B12缺乏，补充肠外维生素B12后全血细胞减少和原始细胞改变有所改善。这凸显了认识到维生素B12缺乏患者的发育异常变化可能具有误导性的重要性。
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