Pernicious Anemia Associated Cobalamin Deficiency and Thrombotic Microangiopathy: Case Report and Review of the Literature
Joint Authors
Yousaf, Farhanah
Spinowitz, Bruce
Charytan, Chaim
Galler, Marilyn
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-06
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
A 43-year-old Hispanic male without significant previous medical history was brought to emergency department for syncope following a blood draw to investigate a 40 lbs weight loss during the past 6 months associated with decreased appetite and progressive fatigue.
The patient also reported a 1-month history of jaundice.
On examination, he was hemodynamically stable and afebrile with pallor and diffuse jaundice but without skin rash or palpable purpura.
Normal sensations and power in all extremities were evident on neurological exam.
Presence of hemolytic anemia, schistocytosis, thrombocytopenia, and elevated lactate dehydrogenase (LDH) was suggestive of thrombotic thrombocytopenic purpura (TTP).
However, presence of leukopenia, macrocytes, and an inadequate reticulocyte response to the degree of anemia served as initial clues to an alternative diagnosis.
Two and one units of packed red blood cells were transfused on day 1 and day 3, respectively.
In addition, one unit of platelets was transfused on day 2.
Daily therapeutic plasma exchange (TPE) was initiated and continued until ADAMTS-13 result ruled out TTP.
A low cobalamin (vitamin B12) level was evident at initial laboratory work-up and subsequent testing revealed positive intrinsic factor-blocking antibodies supporting a diagnosis of pernicious anemia with severe cobalamin deficiency.
Hematological improvement was observed following vitamin B12 supplementation.
The patient was discharged and markedly improved on day 9 with outpatient follow-up for cobalamin supplementation.
American Psychological Association (APA)
Yousaf, Farhanah& Spinowitz, Bruce& Charytan, Chaim& Galler, Marilyn. 2017. Pernicious Anemia Associated Cobalamin Deficiency and Thrombotic Microangiopathy: Case Report and Review of the Literature. Case Reports in Medicine،Vol. 2017, no. 2017, pp.1-8.
https://search.emarefa.net/detail/BIM-1146919
Modern Language Association (MLA)
Yousaf, Farhanah…[et al.]. Pernicious Anemia Associated Cobalamin Deficiency and Thrombotic Microangiopathy: Case Report and Review of the Literature. Case Reports in Medicine No. 2017 (2017), pp.1-8.
https://search.emarefa.net/detail/BIM-1146919
American Medical Association (AMA)
Yousaf, Farhanah& Spinowitz, Bruce& Charytan, Chaim& Galler, Marilyn. Pernicious Anemia Associated Cobalamin Deficiency and Thrombotic Microangiopathy: Case Report and Review of the Literature. Case Reports in Medicine. 2017. Vol. 2017, no. 2017, pp.1-8.
https://search.emarefa.net/detail/BIM-1146919
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1146919