{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:04:31Z","timestamp":1785503071852,"version":"3.56.0"},"reference-count":16,"publisher":"Akademiai Kiado Zrt.","issue":"14","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2026,4,5]]},"abstract":"<jats:p>\n                    A thromboticus microangiopathi\u00e1k (TMA-k) microangiopathi\u00e1s haemolyticus\n                    anaemi\u00e1val, thrombocytopeni\u00e1val \u00e9s szervk\u00e1rosod\u00e1ssal j\u00e1r\u00f3 k\u00f3rk\u00e9pek. Ritka, de\n                    reverzibilis okk\u00e9nt a B\n                    <jats:sub>12<\/jats:sub>\n                    -vitamin- \u00e9s folsavhi\u00e1ny thromboticus\n                    microangiopathia (pseudo-TMA) k\u00e9p\u00e9ben, haemolyticus uraemi\u00e1s szindr\u00f3m\u00e1ra (HUS)\n                    eml\u00e9keztet\u0151 klinikai megjelen\u00e9ssel jelentkezhet, ami jelent\u0151s diagnosztikus\n                    kih\u00edv\u00e1st jelent. Egy 56 \u00e9ves n\u0151betegben s\u00falyos anaemia, thrombocytopenia, akut\n                    vesek\u00e1rosod\u00e1s \u00e9s haemolysis alakult ki. A kivizsg\u00e1l\u00e1s sor\u00e1n kifejezett\n                    folsavhi\u00e1ny, jelent\u0151s macrocytosis (MCV&gt;120 fl), alacsony haptoglobinszint \u00e9s\n                    extr\u00e9m LDH-emelked\u00e9s volt \u00e9szlelhet\u0151. Az ADAMTS13-aktivit\u00e1s cs\u00f6kkent volt, de\n                    nem felelt meg a klasszikus thromboticus thrombocytopeni\u00e1s purpura\n                    krit\u00e9riumainak, m\u00edg a komplementvizsg\u00e1latok szekunder, consumpti\u00f3s aktiv\u00e1ci\u00f3t\n                    igazoltak. Infekci\u00f3s, autoimmun, malignus \u00e9s gy\u00f3gyszeres eredet nem igazol\u00f3dott.\n                    A beteg \u00e1tmeneti folyamatos vesep\u00f3tl\u00f3 kezel\u00e9st, plazmafer\u00e9zist \u00e9s\n                    szteroidkezel\u00e9st ig\u00e9nyelt, majd nagy d\u00f3zis\u00fa folsav- \u00e9s\n                    B\n                    <jats:sub>12<\/jats:sub>\n                    -vitamin-p\u00f3tl\u00e1s indult. A vitaminp\u00f3tl\u00e1st k\u00f6vet\u0151en gyors\n                    reticulocytav\u00e1lasz, a haemolysis megsz\u0171n\u00e9se \u00e9s teljes hematol\u00f3giai remisszi\u00f3\n                    k\u00f6vetkezett be. Az eset r\u00e1vil\u00e1g\u00edt arra, hogy a folsav- \u00e9s\n                    B\n                    <jats:sub>12<\/jats:sub>\n                    -vitaminhi\u00e1ny reverzibilispseudo-TMA-t okozhat, HUS-ra eml\u00e9keztet\u0151\n                    klinikai megjelen\u00e9ssel. A k\u00f3rk\u00e9p korai felismer\u00e9se \u00e9s a c\u00e9lzott vitaminp\u00f3tl\u00e1s\n                    kulcsfontoss\u00e1g\u00fa, mivel megel\u0151zheti a felesleges, invaz\u00edv vagy k\u00f6lts\u00e9ges ter\u00e1pi\u00e1k\n                    alkalmaz\u00e1s\u00e1t. Orv Hetil. 2026; 167(14): 556\u2013559.\n                  <\/jats:p>","DOI":"10.1556\/650.2026.33528","type":"journal-article","created":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T08:01:35Z","timestamp":1775376095000},"page":"556-559","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["B12- \u00e9s folsavhi\u00e1ny okozta thromboticus microangiopathia (pseudo-TMA)"],"prefix":"10.1556","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3721-8091","authenticated-orcid":true,"given":"Krisztina","family":"K\u00f3bor","sequence":"first","affiliation":[{"name":"Borsod-Aba\u00faj-Zempl\u00e9n V\u00e1rmegyei K\u00f6zponti K\u00f3rh\u00e1z \u00e9s Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly Miskolc, Szentp\u00e9teri kapu 72\u201376., 3526 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piroska","family":"Manzel","sequence":"additional","affiliation":[{"name":"Borsod-Aba\u00faj-Zempl\u00e9n V\u00e1rmegyei K\u00f6zponti K\u00f3rh\u00e1z \u00e9s Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly Miskolc, Szentp\u00e9teri kapu 72\u201376., 3526 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"M\u00e1tyus","sequence":"additional","affiliation":[{"name":"Borsod-Aba\u00faj-Zempl\u00e9n V\u00e1rmegyei K\u00f6zponti K\u00f3rh\u00e1z \u00e9s Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, II. Belgy\u00f3gy\u00e1szati Oszt\u00e1ly, Immunol\u00f3giai Szakrendel\u00e9s Miskolc Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Proh\u00e1szka","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Belgy\u00f3gy\u00e1szati \u00e9s Hematol\u00f3giai Klinika, Kutat\u00f3laborat\u00f3rium Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9za","family":"Reusz","sequence":"additional","affiliation":[{"name":"Borsod-Aba\u00faj-Zempl\u00e9n V\u00e1rmegyei K\u00f6zponti K\u00f3rh\u00e1z \u00e9s Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, K\u00f6zponti Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Oszt\u00e1ly Miskolc, Szentp\u00e9teri kapu 72\u201376., 3526 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Fakhouri F, Zuber J, Fr\u00e9meaux-Bacchi V, et al. Haemolytic uraemic\n                    syndrome. Lancet 2017; 390(10095): 681-696. Erratum: Lancet 2017; 390(10095):\n                    648. https:\/\/doi.org\/10.1016\/S0140-6736(17)30062-4","DOI":"10.1016\/S0140-6736(17)30062-4"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Noris M, Remuzzi G. Atypical hemolytic-uremic syndrome. N Engl J\n                    Med. 2009; 361: 1676-1687.\n                    https:\/\/doi.org\/10.1056\/NEJMra0902814","DOI":"10.1056\/NEJMra0902814"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Szarvas N, Szil\u00e1gyi \u00c1, Csuka D, et al. Genetic analysis and\n                    functional characterization of novel mutations in a series of patients with\n                    atypical hemolytic uremic syndrome. 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Eg\u00e9szs\u00e9g\u00fcgyi szakmai ir\u00e1nyelv - A thrombotikus\n                    thrombocytopeni\u00e1s purpura (TTP) \u00e9s a haemolytikus uraemi\u00e1s szindr\u00f3ma (HUS)\n                    kezel\u00e9s\u00e9r\u0151l.] Orv Hetil. 2023; 164(Suppl 1): 3-59. [Hungarian]\n                        https:\/\/doi.org\/10.1556\/650.2023.32878","DOI":"10.1556\/650.2023.32878"},{"key":"R14","unstructured":"Go RS, Winters JL, Leung N. Thrombotic microangiopathy associated\n                    with vitamin B12 deficiency. Blood Rev. 2023; 58:\n                    101008."},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Morrissey D, Sun Y, Koilpillai S, et al. Pseudo-thrombotic\n                    microangiopathy secondary to vitamin B12 deficiency. 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