# Pseudomicroangiopathic Thrombotic Syndrome: Unveiling the Vitamin B12 Deficiency Connection

## TL;DR

This case report shows how vitamin B12 deficiency can mimic a severe blood disorder and highlights the importance of early diagnosis and treatment.

## Contribution

The paper presents a rare case linking vitamin B12 deficiency to TMA-like symptoms, emphasizing the need for clinical awareness.

## Key findings

- A patient with TMA-like symptoms was diagnosed with pernicious anemia due to vitamin B12 deficiency.
- Treatment with vitamin B12 supplementation led to rapid clinical improvement.
- The case highlights the risk of misdiagnosis without considering vitamin B12 deficiency.

## Abstract

Pernicious anemia, a manifestation of vitamin B12 deficiency, can present with a spectrum of hematological abnormalities, sometimes mimicking more severe conditions such as thrombotic microangiopathy (TMA). This case report details a 53-year-old female who presented with significant weight loss, watery diarrhea, and jaundice. Laboratory investigations revealed pancytopenia, hemolysis, and schistocytes, initially suggesting a diagnosis of microangiopathic hemolytic anemia (MAHA). However, significantly low vitamin B12 levels and subsequent bone marrow examination confirmed pernicious anemia with megaloblastic changes. This case underscores the importance of considering vitamin B12 deficiency in the differential diagnosis of patients presenting with TMA-like symptoms. Early recognition and treatment with vitamin B12 supplementation led to rapid clinical improvement and the resolution of symptoms. This report highlights the need for heightened clinical awareness of atypical presentations of pernicious anemia to prevent misdiagnosis and ensure timely, effective treatment.