Pseudo-thrombotic Microangiopathy Caused by Acquired Cobalamin Deficiency Due to Unintentional Neglect

Acquired vitamin B12 (VB12) deficiency is a rare cause of thrombotic microangiopathy (TMA). We experienced an 86-year-old Japanese woman who presented with coma, renal dysfunction, and microangiopathic hemolytic anemia. Although we initially considered thrombotic thrombocytopenic purpura, we eventua...

Full description

Saved in:
Bibliographic Details
Published in:Internal Medicine 2021/12/01, Vol.60(23), pp.3833-3837
Main Authors: Shigeta, Tomoyuki, Sasaki, Yosuke, Maeda, Tadashi, Hanji, Erika, Urita, Yoshihisa
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Anemia, Hemolytic
Case Report
Differential diagnosis
Female
Gastrectomy
Geriatrics
Hemolytic anemia
Humans
Internal medicine
neglect
Nutrient deficiency
plasma exchange
Purpura, Thrombotic Thrombocytopenic - diagnosis
Purpura, Thrombotic Thrombocytopenic - etiology
Renal function
Thrombocytopenic purpura
Thrombotic Microangiopathies - diagnosis
Thrombotic Microangiopathies - etiology
Thrombotic microangiopathy
Thrombotic thrombocytopenic purpura
Vitamin B 12
Vitamin B 12 Deficiency - complications
Vitamin B 12 Deficiency - diagnosis
vitamin B1
Vitamin B12
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Acquired vitamin B12 (VB12) deficiency is a rare cause of thrombotic microangiopathy (TMA). We experienced an 86-year-old Japanese woman who presented with coma, renal dysfunction, and microangiopathic hemolytic anemia. Although we initially considered thrombotic thrombocytopenic purpura, we eventually diagnosed her to have VB12 deficiency due to inappropriate dietary care based on her low serum VB12 level, social history, and negative parietal cell finding and the presence of intrinsic factor antibody. Because similar cases are expected to increase in today's aging society, our experience underscores the importance of including acquired VB12 deficiency in the differential diagnosis of TMA, even in elderly patients without a history of gastrectomy.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.6660-20