A Rare Case of Vitamin B12 Deficiency as a Cause of Acquired Hemolytic Anemia

Andrew Sagalov^1, , Sujitha Ketineni², Mohammad Hussain² and Ruchika Goel²

¹Department of Internal Medicine, SIU School of Medicine, Springfield, IL, USA

²1Department of Internal Medicine, SIU School of Medicine, Springfield, IL, USA

Cite this paper:
Andrew Sagalov, Sujitha Ketineni, Mohammad Hussain and Ruchika Goel. A Rare Case of Vitamin B12 Deficiency as a Cause of Acquired Hemolytic Anemia. American Journal of Medical Case Reports. 2023; 11(2):16-18. doi: 10.12691/ajmcr-11-2-2

Abstract

An elderly woman was brought to the emergency department following a one-week history of progressively worsening epigastric pain and generalized weakness. Her symptoms began approximately two years before admission; however, she did not seek medical attention as her symptoms were mild. Vital signs were stable on presentation, while her pain persisted following administration of morphine. A computed tomography scan of her abdomen did not identify any acute pathology. Laboratory evaluation revealed megaloblastic anemia, a critically low vitamin B12 count, and evidence of hemolytic anemia (HA). She was treated with cyanocobalamin injections and her abdominal pain resolved. This case demonstrates a rare instance of acquired HA as a complication of vitamin B12 deficiency. Furthermore, our manuscript emphasizes clinicians should recognize megaloblastic anemias are not always macrocytic and to conduct a thorough medical history when evaluating an anemia.

Keywords:
Vitamin B12 hemolytic anemia pernicious anemia Homocysteine

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