{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:30:59Z","timestamp":1787009459596,"version":"build-2736575974"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Parkinson\u2019s 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\u2019s 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\u2019s anemia resolved and was no longer transfusion dependent.<\/jats:p>","DOI":"10.1093\/omcr\/omaf191","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T12:04:04Z","timestamp":1759406644000},"source":"Crossref","is-referenced-by-count":2,"title":["Carbidopa\/levodopa induced severe vitamin B6 deficiency leading to symptomatic transfusion dependent microcytic Anemia"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0995-5160","authenticated-orcid":false,"given":"Byung K","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine, Naval Medical Center San Diego , 34800 Bob Wilson Drive, San Diego, CA 92134 ,","place":["United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime P","family":"Gastwirt","sequence":"additional","affiliation":[{"name":"Department of Hematology & Oncology, Naval Medical Center San Diego , 34800 Bob Wilson Drive, San Diego, CA 92134 ,","place":["United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026042811520643200_ref1","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.3233\/JPD-181474","article-title":"The emerging evidence of the Parkinson pandemic","volume":"8","author":"Dorsey","year":"2018","journal-title":"J Parkinsons Dis"},{"key":"2026042811520643200_ref2","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1212\/WNL.0000000000012868","article-title":"Dopaminergic therapy for motor symptoms in early Parkinson disease practice guideline summary: a report of the AAN guideline subcommittee","volume":"97","author":"Pringsheim","year":"2021","journal-title":"Neurology."},{"key":"2026042811520643200_ref3","doi-asserted-by":"publisher","first-page":"120690","DOI":"10.1016\/j.jns.2023.120690","article-title":"A systematic review of the potential consequences of abnormal serum levels of vitamin B6 in people living with Parkinson\u2019s disease","volume":"450","author":"Modica","year":"2023","journal-title":"J Neurol Sci"},{"key":"2026042811520643200_ref4","doi-asserted-by":"publisher","first-page":"5346","DOI":"10.1182\/blood-2022-169421","article-title":"Conditional synthetic lethality between the initial steps of Heme biosynthesis and pyridoxine metabolism during erythropoiesis","volume":"140","author":"Ducamp","year":"2022","journal-title":"Blood."},{"key":"2026042811520643200_ref5","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1159\/000525234","article-title":"Refractory seizures secondary to vitamin B6 deficiency in Parkinson disease: the role of carbidopa-levodopa","volume":"14","author":"Wise","year":"2022","journal-title":"Case Rep Neurol"},{"key":"2026042811520643200_ref6","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00702-011-0689-3","article-title":"Malnutritional neuropathy under intestinal levodopa infusion","volume":"119","author":"Klostermann","year":"2012","journal-title":"J Neural Transm (Vienna)"},{"key":"2026042811520643200_ref7","doi-asserted-by":"publisher","first-page":"3719","DOI":"10.2169\/internalmedicine.9577-22","article-title":"Vitamin B6 deficiency Anemia attributed to levodopa\/carbidopa intestinal gel therapy for Parkinson's disease: a diagnostic pitfall for myelodysplastic syndrome with ring Sideroblasts","volume":"61","author":"Yasuda","year":"2022","journal-title":"Intern Med"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/4\/omaf191\/68177029\/omaf191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/4\/omaf191\/68177029\/omaf191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:52:14Z","timestamp":1777391534000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omaf191\/8663960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,12]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omaf191","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,4]]},"article-number":"omaf191"}}