六个月内维生素B₁₂缺乏所致的严重溶血性贫血
Severe Hemolytic Anemia due to Vitamin B12 Deficiency in Six Months.
作者信息
Sadagopan Narayanan
机构信息
University of Massachusetts Medical School, Worcester, MA 01655, USA.
出版信息
Hematol Rep. 2022 Jun 22;14(3):210-212. doi: 10.3390/hematolrep14030028.
Abstract
Gastric bypass is a common cause of vitamin B12 deficiency. It can lead to patients presenting with symptoms of anemia. The body has significant reserves of vitamin B12 and loses vitamin B12 slowly. The following case is of a patient who underwent a gastric bypass five years ago and whose hemoglobin (Hgb) dropped from 12.2 g/dL to 4.4 g/dL over six months due to questionable adherence to vitamin supplements. Further work-up showed hemolytic anemia and thrombocytopenia due to a very low vitamin B12 level of 47 pg/mL, with his blood counts improving with vitamin B12 supplementation. The case points to the importance of thinking about vitamin deficiency as a cause of hemolysis to avoid unnecessary procedures.
摘要
胃旁路手术是维生素B12缺乏的常见原因。它可导致患者出现贫血症状。人体有大量的维生素B12储备，且维生素B12流失缓慢。以下病例是一位五年前接受胃旁路手术的患者，由于对维生素补充剂的依从性存疑，其血红蛋白（Hgb）在六个月内从12.2 g/dL降至4.4 g/dL。进一步检查显示，由于维生素B12水平极低，仅为47 pg/mL，导致了溶血性贫血和血小板减少，补充维生素B12后其血细胞计数有所改善。该病例指出了将维生素缺乏视为溶血原因以避免不必要检查的重要性。
相似文献
1
Severe Hemolytic Anemia due to Vitamin B12 Deficiency in Six Months.六个月内维生素B₁₂缺乏所致的严重溶血性贫血
Hematol Rep. 2022 Jun 22;14(3):210-212. doi: 10.3390/hematolrep14030028.
2
A Case of Pernicious Anemia Presenting With Severe Hemolysis.一例以严重溶血为表现的恶性贫血病例。
Cureus. 2023 Dec 14;15(12):e50534. doi: 10.7759/cureus.50534. eCollection 2023 Dec.
3
Vitamin B12 deficiency presenting as pseudo-thrombotic microangiopathy: a case report and literature review.以假性血栓性微血管病为表现的维生素B12缺乏症：一例报告及文献综述
Clin Pharmacol. 2019 Aug 27;11:127-131. doi: 10.2147/CPAA.S207258. eCollection 2019.
4
Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy.一名仅接受母乳喂养的 5 月龄意大利婴儿，母亲在怀孕期间接受多种维生素补充，患有严重的维生素 B12 缺乏症。
BMC Pediatr. 2012 Jun 24;12:85. doi: 10.1186/1471-2431-12-85.
5
[Psychiatric manifestations of vitamin B12 deficiency: a case report].[维生素B12缺乏的精神症状：一例报告]
Encephale. 2003 Nov-Dec;29(6):560-5.
6
Chronic Atrophic Gastritis Presenting as Hemolytic Anemia due to Severe Vitamin B12 Deficiency.因严重维生素B12缺乏导致溶血性贫血的慢性萎缩性胃炎
Case Rep Hematol. 2021 Jul 31;2021:9571072. doi: 10.1155/2021/9571072. eCollection 2021.
7
Enteral Vitamin B12 Supplementation Is Effective for Improving Anemia in Patients Who Underwent Total Gastrectomy.肠内补充维生素 B12 可有效改善全胃切除术后患者的贫血。
Oncology. 2021;99(4):225-233. doi: 10.1159/000513888. Epub 2021 Feb 18.
8
Vitamin B12 and vitamin d deficiencies: an unusual cause of Fever, severe hemolytic anemia and thrombocytopenia.维生素B12和维生素D缺乏：发热、严重溶血性贫血和血小板减少症的罕见病因。
J Family Med Prim Care. 2015 Jan-Mar;4(1):145-8. doi: 10.4103/2249-4863.152276.
9
Vitamin B12 Deficiency Disguised As Hemolytic Anemia: A Case Presentation.伪装成溶血性贫血的维生素B12缺乏症：病例报告
Cureus. 2024 Jan 7;16(1):e51815. doi: 10.7759/cureus.51815. eCollection 2024 Jan.
10
Pernicious anemia presenting with dysphagia and melanoderma: a confusing manifestation.
Future Sci OA. 2024 May 20;10(1):FSO969. doi: 10.2144/fsoa-2023-0176. eCollection 2024.
引用本文的文献
1
A Rare Case of Hemolysis Secondary to Severe Vitamin B12 Deficiency.一例罕见的严重维生素B12缺乏继发溶血病例。
J Brown Hosp Med. 2024 Oct 1;3(4):1-4. doi: 10.56305/001c.122624. eCollection 2024.
2
A Case of Pernicious Anemia Presenting With Severe Hemolysis.一例以严重溶血为表现的恶性贫血病例。
Cureus. 2023 Dec 14;15(12):e50534. doi: 10.7759/cureus.50534. eCollection 2023 Dec.
3
Pseudo-Thrombotic Thrombocytopenic Purpura Due to Severe Vitamin B12 Deficiency: A Case Report.重度维生素B12缺乏所致假性血栓性血小板减少性紫癜：一例报告
Cureus. 2023 Jun 10;15(6):e40212. doi: 10.7759/cureus.40212. eCollection 2023 Jun.
4
A Case Report of Cold Agglutinin Disease, Severe B12 Deficiency, and Pernicious Anemia: A Deadly Coincidence.冷凝集素病、重度维生素B12缺乏与恶性贫血病例报告：致命巧合
Cureus. 2023 Apr 27;15(4):e38208. doi: 10.7759/cureus.38208. eCollection 2023 Apr.
5
Non-immune Intravascular Hemolytic Anemia, an Unusual Presentation of Severe Vitamin B-12 Deficiency.非免疫性血管内溶血贫血，一种严重维生素B12缺乏的不寻常表现。
Cureus. 2022 Jul 2;14(7):e26507. doi: 10.7759/cureus.26507. eCollection 2022 Jul.
本文引用的文献
1
An evaluation of existing manual blood film schistocyte quantitation guidelines and a new proposed method.对现有手工血涂片裂红细胞定量指南及一种新提出方法的评估。
Pathology. 2021 Oct;53(6):746-752. doi: 10.1016/j.pathol.2021.01.008. Epub 2021 Apr 15.
2
Thrombotic Microangiopathy-Like Hemolysis in Vitamin B12 Deficiency-Related Macrocytic Anemia.维生素B12缺乏相关巨幼细胞贫血中的血栓性微血管病样溶血
Clin Lab. 2018 Apr 1;64(4):639-643. doi: 10.7754/Clin.Lab.2017.171138.
3
Peripheral neuropathy due to vitamin deficiency, toxins, and medications.由维生素缺乏、毒素和药物引起的周围神经病变。
Continuum (Minneap Minn). 2014 Oct;20(5 Peripheral Nervous System Disorders):1293-306. doi: 10.1212/01.CON.0000455880.06675.5a.
4
Vitamin B12 deficiency in patients undergoing bariatric surgery: preventive strategies and key recommendations.接受减重手术患者的维生素 B12 缺乏：预防策略和关键建议。
Surg Obes Relat Dis. 2013 Nov-Dec;9(6):1013-9. doi: 10.1016/j.soard.2013.04.017. Epub 2013 May 24.
5
Systematic review on daily vitamin B12 losses and bioavailability for deriving recommendations on vitamin B12 intake with the factorial approach.系统评价每日维生素 B12 损失和生物利用度，以事实法为依据提出维生素 B12 摄入量建议。
Ann Nutr Metab. 2013;62(4):311-22. doi: 10.1159/000346968. Epub 2013 Jun 20.
6
Diagnosis and management of clinical and subclinical cobalamin deficiencies: why controversies persist in the age of sensitive metabolic testing.临床和亚临床钴胺素缺乏症的诊断和管理：为什么在代谢敏感检测时代仍存在争议。
Biochimie. 2013 May;95(5):1047-55. doi: 10.1016/j.biochi.2013.02.008. Epub 2013 Feb 14.
7
Vitamin B-12.维生素B-12
Adv Nutr. 2012 Jan;3(1):54-5. doi: 10.3945/an.111.001370. Epub 2012 Jan 5.
8
Current hematological findings in cobalamin deficiency. A study of 201 consecutive patients with documented cobalamin deficiency.钴胺素缺乏症的当前血液学表现。对201例有记录的钴胺素缺乏症患者的研究。
Clin Lab Haematol. 2006 Feb;28(1):50-6. doi: 10.1111/j.1365-2257.2006.00755.x.
9
Thrombotic thrombocytopenic purpura without schistocytes on the peripheral blood smear.外周血涂片未见裂红细胞的血栓性血小板减少性紫癜。
South Med J. 2005 Mar;98(3):392-5. doi: 10.1097/01.SMJ.0000136231.83564.F6.
10
A role for homocysteine increase in haemolysis of megaloblastic anaemias due to vitamin B(12) and folate deficiency: results from an in vitro experience.同型半胱氨酸升高在维生素B12和叶酸缺乏所致巨幼细胞贫血溶血中的作用：一项体外实验结果
Biochim Biophys Acta. 2004 Dec 24;1739(1):33-42. doi: 10.1016/j.bbadis.2004.08.005.
Zotero 插件