维生素B12缺乏症误诊为血栓性血小板减少性紫癜：我们能从中吸取什么教训？

Vitamin B12 deficiency misdiagnosed as TTP: What can we learn from it?

作者信息

Lämmle Bernhard, Laemmle Alexander

机构信息

Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

Br J Haematol. 2024 Oct;205(4):1255-1256. doi: 10.1111/bjh.19702. Epub 2024 Aug 11.

DOI:10.1111/bjh.19702

PMID:39128484

Abstract

The case report by Dwyre et al. shows that vitamin B12 deficiency may be misdiagnosed as acute thrombotic thrombocytopenic purpura. Together with similar observations, this underlines that acquired vitamin B12 deficiency-besides the inherited disorder of intracellular cobalamin metabolism, cbl C disease-should be listed as a separate entity of the thrombotic microangiopathies. Commentary on: Dwyre et al. Microangiopathic thrombocytopenia caused by vitamin B12 deficiency responding to plasma exchange. Br J Haematol 2024; 205:1546-1550.

摘要

德怀尔等人的病例报告表明，维生素B12缺乏症可能被误诊为急性血栓性血小板减少性紫癜。结合类似的观察结果，这凸显出除了细胞内钴胺素代谢的遗传性疾病——cbl C病之外，获得性维生素B12缺乏症应被列为血栓性微血管病的一个独立类型。评论文章：德怀尔等人。维生素B12缺乏引起的微血管性血小板减少症对血浆置换有反应。《英国血液学杂志》2024年；205:1546 - 1550。