Salimiaghdam Nasim, Jumaah Omar, Acob Talar, Hakobyan Knkush, Chen Emily
Internal Medicine, Capital Health Regional Medical Center, Trenton, USA.
Internal Medicine, Capital Health Medical Center, Trenton, USA.
Cureus. 2025 Feb 17;17(2):e79176. doi: 10.7759/cureus.79176. eCollection 2025 Feb.
Vitamin B12 deficiency can lead to a wide range of clinical symptoms and may resemble hemolytic anemia due to ineffective red blood cell production and hemolysis occurring within the bone marrow. Identifying this deficiency as a possible cause of hemolysis is essential to prevent misdiagnosis, especially when distinguishing it from thrombotic microangiopathy. We present a case involving a 60-year-old woman with a history of hypertension and type 2 diabetes who came in with symptoms of generalized weakness, dizziness, nausea, and abdominal pain. Laboratory tests showed pancytopenia, macrocytosis, and signs of hemolysis. Further investigation confirmed a severe vitamin B12 deficiency linked to pernicious anemia. After starting weekly intramuscular cyanocobalamin injections for the first month and then switching to monthly injections for four months post-discharge, her blood parameters showed significant improvement. This underlines the vital role of timely diagnosis and following established treatment protocols. This case emphasizes the importance of considering vitamin B12 deficiency as a reversible cause of hemolysis. It highlights the need to differentiate it from more serious hematologic disorders such as thrombotic microangiopathy to ensure proper management.
维生素B12缺乏可导致多种临床症状，由于骨髓内红细胞生成无效和溶血，可能类似于溶血性贫血。将这种缺乏症识别为溶血的可能原因对于防止误诊至关重要，尤其是在将其与血栓性微血管病区分开来时。我们报告一例病例，患者为一名60岁女性，有高血压和2型糖尿病病史，因全身无力、头晕、恶心和腹痛症状前来就诊。实验室检查显示全血细胞减少、大细胞性贫血和溶血迹象。进一步检查证实存在与恶性贫血相关的严重维生素B12缺乏。在第一个月开始每周肌肉注射氰钴胺，出院后四个月改为每月注射后，她的血液参数显示有显著改善。这强调了及时诊断和遵循既定治疗方案的重要作用。该病例强调了将维生素B12缺乏视为溶血的可逆原因的重要性。它突出了将其与血栓性微血管病等更严重的血液系统疾病区分开来以确保正确管理的必要性。
