{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:16:07Z","timestamp":1776644167911,"version":"3.51.2"},"reference-count":6,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T00:00:00Z","timestamp":1662163200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2022,9,3]]},"abstract":"<jats:p>Background. Clinical B12 deficiency with hematological or neurological manifestations is rare. An unusual manifestation of B12 deficiency is pseudo-thrombotic microangiopathy (TMA), which is characterized by hemolytic anemia, thrombocytopenia, and schistocytosis and only occurs in 2.5% of those with B12 deficiency. Pseudo-TMA is misdiagnosed as thrombotic thrombocytopenic purpura (TTP) in 40% of cases, resulting in misguided treatment including plasmapheresis. Case. A 44-year-old Hispanic presented with 3 weeks of progressively worsening non-radiating chest pain, fatigue, and shortness of breath (SOB). Laboratory findings revealed severe pancytopenia and macrocytosis with a hemoglobin of 5.4\u2009g\/dL, mean corpuscular volume of 116.3\u2009fL, and vitamin B12 low at 149 pg\/mL. She was diagnosed with pseudo-TMA and after starting 1000 micrograms of parenteral vitamin B12 injections daily and discontinuing plasmapheresis and steroid administration, she improved. Conclusion. Failure to recognize pseudo-TMA often results in unnecessary treatment with plasmapheresis and delays appropriate treatment with vitamin B12 supplementation. It is therefore extremely important to consider pseudo-TMA as a differential diagnosis in patients that present with hemolytic anemia, thrombocytopenia, and schistocytosis.<\/jats:p>","DOI":"10.1155\/2022\/7306070","type":"journal-article","created":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T20:35:05Z","timestamp":1662237305000},"page":"1-3","source":"Crossref","is-referenced-by-count":13,"title":["Pseudo-Thrombotic Microangiopathy Secondary to Vitamin B12 Deficiency"],"prefix":"10.1155","volume":"2022","author":[{"given":"Dylan","family":"Morrissey","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuheng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarina","family":"Koilpillai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Kropf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-8538","authenticated-orcid":true,"given":"Steve J.","family":"Carlan","sequence":"additional","affiliation":[{"name":"Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.40"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2018.01.003"},{"key":"3","first-page":"5576","article-title":"Kyaw Zin Thein, and Thein Hlaing Oo. Vitamin B12 deficiency-related pseudo-thrombotic microangiopathy might be misdiagnosed and treated with plasma product therapy: review of the literature and analysis of the reported cases","volume":"130","author":"A. M. Tun","year":"2017","journal-title":"Blood"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2013.07.018"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.9097"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.14740\/jh889"}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2022\/7306070.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2022\/7306070.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2022\/7306070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T20:35:08Z","timestamp":1662237308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/crim\/2022\/7306070\/"}},"subtitle":[],"editor":[{"given":"Massimo","family":"Conese","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,3]]},"references-count":6,"alternative-id":["7306070","7306070"],"URL":"https:\/\/doi.org\/10.1155\/2022\/7306070","relation":{},"ISSN":["1687-9635","1687-9627"],"issn-type":[{"value":"1687-9635","type":"electronic"},{"value":"1687-9627","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9,3]]}}}