Vitamin B12 Deficiency Masked By Hemolytic Anemia

3/12/01  (Sattari)

RE:  A 36 y.o. female was admitted for DKA and found to be anemic.  Laboratory values supported a hemolytic anemia.  However, we found out that this patient had B12 deficiency and the hemolysis corrected after  vitamin B12 replacement.

Question: Is there an association between B12 deficiency and hemolytic anemia?

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Unique Identifier: 90169053

Authors: Rabinowitz AP. Sacks Y. Carmel R.

Institution: Department of Medicine, Los Angeles County-USC Medical Center.

Abstract: Pernicious anemia appears to be autoimmune in origin and is associated with immune disorders of several organ systems. We report 4 patients with pernicious anemia and immune cytopenias, an association that may sometimes pose diagnostic problems unless specifically considered. Pernicious anemia coexisted with or was closely followed by idiopathic thrombocytopenic purpura in 3 patients and by autoimmune hemolytic anemia in a 4th patient. In addition to cobalamin therapy, all patients required corticosteroids (2 also received danazol), while 1 also required splenectomy. All 4 patients were women. The 3 patients with idiopathic thrombocytopenic purpura were also blood group O and were iron-deficient. Autoimmune cytopenias may occur in patients with treated or untreated pernicious anemia and require specific therapy. [References: 27]

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Unique Identifier: 78137094

Authors: Salvidio E. Venzano C. Boccaccio P. Ravazzolo R. Gaetani GF. Ajmar F.