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- W2555572151 abstract "Introduction: The classic presentation of cobalamin deficiency consists of a macrocytic anemia with or without neurologic manifestations. A common cause of cobalamin deficiency is pernicious anemia, an autoimmune condition in which anti-intrinsic factor antibodies are present. We present a case of pernicious anemia masked by features consistent with thrombotic thrombocytopenic purpura, as well as a review of similar cases in the literature. Case presentation: A 31 year old male presented to the Emergency Department with symptomatic anemia and altered mental status. Laboratory data was significant for microangiopathic hemolytic anemia and thrombocytopenia. A clinical diagnosis of thrombotic thrombocytopenic purpura was made and plasma exchange was initiated. Due to the lack of improvement with plasma exchange, additional laboratory studies were obtained which showed cobalamin deficiency, intrinsic factor antibodies, and ADAMTS13 levels within normal limits. The patient’s clinical and laboratory status improved with parenteral cobalamin replacement and discontinuation of plasma exchange. Discussion: Severe cobalamin deficiency can present as a severe microangiopathic hemolytic anemia that responds rapidly to cobalamin replacement. Key differentiating considerations from thrombotic thrombocytopenic purpura are markedly elevated lactate dehydrogenase, low reticulocyte count, six-lobed polymorphonuclear white blood cells on the peripheral blood smear, and markedly low serum cobalamin." @default.
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- W2555572151 date "2015-01-01" @default.
- W2555572151 modified "2023-10-17" @default.
- W2555572151 title "Thrombotic thrombocytopenic purpura or cobalamin deficiency? A case report and review" @default.
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- W2555572151 doi "https://doi.org/10.15761/ccrr.1000152" @default.
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