scholarly journals Severe Vitamin B12 Deficiency in Pregnancy Mimicking HELLP Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shravya Govindappagari ◽  
Michelle Nguyen ◽  
Megha Gupta ◽  
Ramy M. Hanna ◽  
Richard M. Burwick
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Thrombotic Microangiopathy ◽  
Hellp Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Vitamin B12 Deficiency ◽  
Severe Vitamin ◽  
Elevated Liver Enzymes ◽  
B12 Deficiency ◽  
In Pregnancy

Severe vitamin B12 deficiency may present with hematologic abnormalities that mimic thrombotic microangiopathy disorders such as hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. We report a patient diagnosed with severe vitamin B12 deficiency, following termination of pregnancy for suspected preeclampsia and HELLP syndrome at 21 weeks’ gestation. When hemolysis and thrombocytopenia persisted after delivery, testing was performed to rule out other etiologies of thrombotic microangiopathy, including atypical hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and vitamin B12 deficiency. This work-up revealed undetectable vitamin B12 levels and presence of intrinsic factor antibodies, consistent with pernicious anemia. Parenteral B12 supplementation was initiated, with subsequent improvement in hematologic parameters. Our case emphasizes the importance of screening for B12 deficiency in pregnancy, especially in at-risk women with unexplained anemia or thrombocytopenia. Moreover, providers should consider B12 deficiency and pernicious anemia in the differential diagnosis of pregnancy-associated thrombotic microangiopathy.

scholarly journals Life-threatening Pseudo-thrombotic Microangiopathy Caused by Severe Vitamin B12 Deficiency

2021 ◽  
Vol 9 (11) ◽  
pp. 532-534
Author(s):  
Ziad Abuhelwa ◽  
Talal Khan ◽  
Rana Daas ◽  
Sami Ghazaleh ◽  
Ragheb Assaly
Keyword(s):  
Vitamin B12 ◽  
Thrombotic Microangiopathy ◽  
Vitamin B12 Deficiency ◽  
Severe Vitamin ◽  
Life Threatening ◽  
B12 Deficiency

RELATIONSHIP OF MATERNAL VITAMIN B12 STATUS IN PREGNANCY WITH PRETERM BIRTH AND MATERNAL HEALTH RISKS

2020 ◽  
pp. 32-38
Author(s):  
VICTORIA LAZAROVA SPASOVA ◽  
LILIA IVANOVA KOLEVA ◽  
MARIETA ANTONOVA POPOVA ◽  
VALENTINA BOYANOVA PETKOVA ◽  
MILEN VENTZISLAVOV DIMITROV
Keyword(s):  
Preterm Birth ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Inverse Association ◽  
Maternal Vitamin ◽  
B12 Deficiency ◽  
The Impact ◽  
In Pregnancy

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.

Metabolic Interrelationship between Vitamin B12 and Ascorbic Acid in Pernicious Anemia

Blood ◽  
1968 ◽  
Vol 31 (1) ◽  
pp. 55-65 ◽  
Author(s):  
SIGMUND BENHAM KAHN ◽  
ISADORE BRODSKY ◽  
Sandra A. Fein
Keyword(s):  
Ascorbic Acid ◽  
Vitamin C ◽  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Vitamin B12 Deficiency ◽  
Biochemical Index ◽  
Plasma Ascorbate ◽  
B12 Deficiency ◽  
Future Work

Abstract An interrelationship between vitamin C and vitamin B12 was studied in three patients with vitamin B12 deficiency associated with pernicious anemia. Subnormal plasma ascorbate concentrations were found prior to therapy confirming previous observations. Following vitamin B12 administration and utilizing methylmalonate (MMA) excretion as a biochemical index of vitamin B12 deficiency, low plasma ascorbate concentrations persisted until MMA excretion was abolished. In two patients, RBC vitamin B12 activity was also serially measured in order to evaluate its sensitivity as an index of vitamin B12 stores when compared to MMA excretion. The data demonstrate that in these two vitamin B12-deficient patients undergoing slow repletion therapy, RBC vitamin B12 activity returns to normal before MMA excretion is abolished. Whether continued MMA excretion in these patients indicates a greater sensitivity of MMA excretion as an index of deficiency of vitamin B12 stores than does RBC vitamin B12 activity remains to be answered by future work.

scholarly journals Chromosomal Aberrations in Pernicious Anemia

Blood ◽  
1965 ◽  
Vol 25 (5) ◽  
pp. 662-682 ◽  
Author(s):  
KOSMAS A. KIOSSOGLOU ◽  
W. J. MITUS ◽  
WILLIAM DAMESHEK
Keyword(s):  
Vitamin B12 ◽  
Pernicious Anemia ◽  
Chromosomal Aberrations ◽  
Peripheral Blood ◽  
Vitamin B12 Deficiency ◽  
Common Finding ◽  
Morphological Abnormalities ◽  
G 21 ◽  
B12 Deficiency ◽  
Chromatin Material

Abstract Numerical and morphologic chromosomal aberrations were demonstrated in three cases of pernicious anemia in relapse. The morphological abnormalities including chromatid breaks, gaps and "giant" chromosomes were reduced in remission following vitamin B12 therapy. The numerical changes consisted of aneuploidy (45 and 44 chromosomes) with the most common finding encountered (6 to 100 per cent of the cells) being monosomy involving the G 21 chromosome. This was present, not only in the marrow cells, but also in other tissues, e.g., peripheral blood and possibly skin fibroblasts, thus suggesting a more generalized disorder. The numerical anomalies persisted in remission. It is postulated that the structural anomalies, namely chromatid breaks, gaps, acentric fragments and "giant" chromosomes are related to vitamin B12 deficiency and are correctable. The cause of the aneuploidy, since it was not correctable by treatment, is not clear. Since the patients were not studied before the disease had ensued, a congenital or acquired predisposition to megaloblastosis on the basis of G 21 monosomy cannot be excluded. The origin and significance of the extra chromatin material translocated onto the short arms of G 21 chromosomes in cases 1 and 3 remains unexplained.

Thrombotic Microangiopathy-Like Hemolysis in Vitamin B12 Deficiency-Related Macrocytic Anemia

2018 ◽  
Vol 64 (04/2018) ◽  
Author(s):  
Masayoshi Yamanishi ◽  
Shigeru Koba ◽  
Takaaki Jo ◽  
Tohru Kotera ◽  
Shinsaku Imashuku
Keyword(s):  
Vitamin B12 ◽  
Thrombotic Microangiopathy ◽  
Macrocytic Anemia ◽  
Vitamin B12 Deficiency ◽  
B12 Deficiency
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