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December 8, 2025BloodOpen Access

Pseudo-thrombotic microangiopathy secondary to severe vitamin B12 deficiency: A case series

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Authors

PYPaul Youn

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Overview

Case series identifies vitamin B12 deficiency as a TTP mimic, highlighting its role in microangiopathic hemolytic anemia.

Key Points

  • To highlight how severe vitamin B12 deficiency can present like thrombotic microangiopathy.
  • Case series of three patients with symptoms resembling TTP.
  • Laboratory assessments included hemoglobin, platelet count, LDH, haptoglobin, and vitamin B12 levels.
  • Patients were evaluated for ADAMTS13 activity and intrinsic factor antibodies.
  • All patients had preserved ADAMTS13 activity and low serum B12.
  • Diagnosis of TTP was initially made for two patients requiring plasmapheresis.
  • All patients responded positively to cyanocobalamin therapy, leading to recovery of hemolysis and platelet counts.

Cite This Study

Paul Youn (2025) studied this question.

synapsesocial.com/papers/69362f364fa91c937236d358https://doi.org/10.1182/blood-2025-1108
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A51-32 Severe Vitamin B12 Deficiency Mimicking TTP: A Case of Pseudo-TMA2026
  2. 2Vitamin B12 deficiency in thrombotic thrombocytopenic purpura-like cases2024
  3. 3C51-09 Thrombotic Thrombocytopenic Purpura or Pseudo-Thrombotic Microangiopathy: A Rare Presentation of Pernicious Anemia2026
  4. 4Vitamin <scp>B12</scp> Deficiency‐Associated Pseudo‐Thrombotic Microangiopathy in a Patient on Longstanding Oral <scp>B12</scp> Supplementation2026 · 1 citations
  5. 5Pernicious Anemia Presenting as Pseudo-Thrombotic Microangiopathy: A Case Report2026