维生素B12缺乏症在血栓性血栓细胞缩性紫外线等病例中
Inemesit Akpan1, Ghida Akhdar1, Kaelan Dawson2
1Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
European journal of case reports in internal medicine
|October 7, 2024
概括
严重的维生素B12缺乏症可以模仿血栓性微血管病变 (TMA),这种情况通常表现为贫血,血小板数量低和器官损伤. 早期检测低维生素B12水平对于迅速有效地管理这种TMA模仿者至关重要.
科学领域:
- 血液学 血液学 血液学
- 内部医学 内部医学
- 营养科学 营养科学
背景情况:
- 血栓性微血管病变 (TMA) 涉及微血管病变的血液溶解性贫血,血栓缩,以及因内皮损伤和血小板激活而导致的器官损伤.
- 维生素B12 (科巴胺) 缺乏症可能与TMA类似,这种情况被称为代谢介导的TMA (MM-TMA).
研究的目的:
- 突出维生素B12缺乏症的不同临床表现.
- 要强调的是,严重的维生素B12缺乏症可以模仿血栓性血栓细胞缩性紫外线 (TTP).
主要方法:
- 一份病例报告显示,一名60岁的女性出现了模仿TTP的症状.
- 实验室调查,包括血分析,ADAMTS13活动测定.
- 根据假定的TTP诊断开始治疗,然后根据进一步发现进行调整.
主要成果:
- 患者出现了贫血,血小板减少,急性功能衰竭和精神状态改变,导致推测TTP诊断.
- 进行了TTP的初始治疗,但随后的正常ADAMTS13活动排除了TTP.
- 在开始维生素B12替代疗法后,包括脑病变和血液溶解在内的症状的消失.
结论:
- 严重的维生素B12缺乏症可以呈现为微血管病性血液溶解性贫血,模仿TTP.
- 在患有血液溶解标志物,低维生素B12和低网红细胞计数的患者中考虑维生素B12缺乏症.
- 早期诊断和维生素B12缺乏的管理对于解决MM-TMA至关重要.
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