Neglect‐induced pseudo‐thrombotic thrombocytopenic purpura due to vitamin B12 deficiency

Although thrombotic thrombocytopenic purpura (TTP) is rare, early diagnosis and treatment are important for decreasing the mortality rate. Acquired vitamin B12 deficiency is frequently overlooked because of its rarity in developed countries, particularly in children and adolescents. The hematologica...

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Bibliographic Details
Published in:Pediatrics international 2015-10, Vol.57 (5), p.988-990
Main Authors: Asano, Takeshi, Narazaki, Hidehiko, Kaizu, Kiyohiko, Matsukawa, Shouhei, Takema‐Tochikubo, Yuki, Fujii, Shuichi, Saitoh, Nobuyuki, Mashiko, Kunihiko, Fujino, Osamu
Format: Article
Language:English
Subjects:
Adolescent
Anemia
Biopsy
Delayed Diagnosis
Diagnosis, Differential
Female
Humans
Industrialized nations
Malnutrition
Malnutrition - blood
Malnutrition - complications
Malnutrition - diagnosis
Mortality
neglect
Neglected Diseases
Pediatrics
pseudo‐thrombotic thrombocytopenic purpura
Purpura, Thrombotic Thrombocytopenic - diagnosis
Purpura, Thrombotic Thrombocytopenic - etiology
Time Factors
Tomography, X-Ray Computed
Vitamin B 12 Deficiency - blood
Vitamin B 12 Deficiency - complications
vitamin B12 deficiency
Vitamin D
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Summary:Although thrombotic thrombocytopenic purpura (TTP) is rare, early diagnosis and treatment are important for decreasing the mortality rate. Acquired vitamin B12 deficiency is frequently overlooked because of its rarity in developed countries, particularly in children and adolescents. The hematological changes in vitamin B12 deficiency present as megaloblastic anemia, increased lactate dehydrogenase, vasoconstriction, increased platelet aggregation, and abnormal activation of the coagulation followed by microangiopathy as well as neutropenia and thrombocytopenia. We report herein the case of a 15‐year‐old girl who had been neglected, which might have caused pseudo‐TTP through malnutrition, particularly vitamin B12 deficiency. When we encounter cases of TTP in children, clinicians must be aware of the possibility of malnutrition, particularly with vitamin B12 deficiency, even in developed countries, and investigate the cause of malnutrition including neglect.
ISSN:1328-8067
1442-200X
DOI:10.1111/ped.12718