Thrombotic microangiopathy-like hemolysis in vitamin B12 deficiency-related megaloblastic macrocytic anemia

Abstract

Vitamin B12 deficiency is common in Turkish population. Depending on the severity of B12 deficiency, patients may present with various clinical conditions and laboratory findings. B12 deficiency may manifest as thrombotic microangiopathy-like hemolysis. B12 deficiency presenting with thrombotic microangiopathy-like hemolysis may be called pseudothrombotic microangiopathy. Pseudothrombotic microangiopathy is anemia, thrombocytopenia, and schistocytosis caused by vitamin B12 deficiency. Pseudothrombotic microangiopathy may be mistakenly confused with microangiopathic hemolytic anemia, which can lead to confusion about the appropriate treatment approaches. Assessment of lactate dehydrogenase, reticulocyte count, bilirubin, and platelet counts may allow pseudothrombotic microangiopathy to be distinguished from a true microangiopathic hemolytic anemia. In this article, we report a case of pseudothrombotic microangiopathy due to severe vitamin B12 deficiency.