Sadagopan Narayanan
University of Massachusetts Medical School, Worcester, MA 01655, USA.
Hematol Rep. 2022 Jun 22;14(3):210-212. doi: 10.3390/hematolrep14030028.
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.
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。
