Unusual Presentation of Vitamin B1 Deficiency Mimickig Heolytic Anemia

Vitamin B12 deficiency is most often associated with megaloblastic anemia, glossitis, and neurological manifestations. However, in rare presentations, it may mimic hemolytic anemia due to ineffective erythropoiesis and intramedullary destruction of red blood cells. We present a short communication on an adult patient who exhibited pallor, jaundice, elevated lactate dehydrogenase (LDH), indirect hyperbilirubinemia, and reticulocytosis—features initially suggestive of hemolytic anemia. Peripheral smear revealed macrocytosis with hypersegmented neutrophils, and serum vitamin B12 levels were markedly reduced. Following parenteral vitamin B12 supplementation, rapid hematological recovery and normalization of hemolysis parameters were observed. This case highlights the importance of considering vitamin B12 deficiency in the differential diagnosis of hemolytic anemia–like presentations, particularly in populations at risk of nutritional deficiency. Early recognition can prevent unnecessary investigations, avert neurological sequelae, and ensure prompt, cost-effective treatment.