In pregnancy, when severe vitamin B12 deficiency goes untreated, it can have profound effects, including severe anemia, peripheral neuropathy, cognitive decline, neuropsychiatric manifestations, microangiopathic hemolytic anemia, and thrombocytopenia mimicking other thrombotic microangiopathy disorders, such as atypical hemolytic uremic syndrome (aHUS), hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, and thrombotic thrombocytopenic purpura (TTP).It is crucial to rule out TTP, aHUS, and vitamin B12 deficiency because these disorders have established nondelivery approaches to treatment.The only proven treatment for HELLP syndrome and pre-eclampsia is delivery.Here is a case of 22-year-old gravida 2 abortion 1 with 32 weeks period of gestation who presented with features mimicking HELLP syndrome and was diagnosed to have low vitamin B12 level and improved after vitamin B12 correction.This highlights the significance of vitamin B12 deficiency screening during pregnancy, especially in thrombocytopenia/unexplained anemia.
Ramamoorthy et al. (Wed,) studied this question.