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Carbidopa/levodopa induced severe vitamin B6 deficiency leading to symptomatic transfusion dependent microcytic
Byung K Lee1, Jaime P Gastwirt2
1Department of Medicine, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, United States of America.
Abstract:
Parkinson's Disease is on the rise over the coming decades with expectations that more patients will be prescribed levodopa therapy. This case presents a patient with Parkinson's Disease who presented with severe symptomatic microcytic anemia. He was transfusion dependent during his extensive work up that occurred during both inpatient hospitalization and outpatient hematology visits. This was negative for iron deficiency, infectious etiology, hemolysis, active bleeding, bone marrow failure, myelodysplasia or hematologic malignancy. However, patient was found to have a critically low vitamin B6 level. Following initiation of vitamin B6 supplementation, patient's anemia resolved and was no longer transfusion dependent.
Insights
A Parkinson's Disease patient with severe anemia, unresponsive to standard treatments, was successfully treated with vitamin B6 supplementation. This highlights vitamin B6 deficiency as a potential cause of anemia in Parkinson's Disease patients.
Area of Science:
- Neurology
- Hematology
- Nutritional Science
Background:
- Parkinson's Disease prevalence is increasing, with rising levodopa therapy use.
- Anemia is a common complication in Parkinson's Disease patients.
- Standard anemia workups often fail to identify the underlying cause in some Parkinson's Disease patients.
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