{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:17:37Z","timestamp":1787847457890,"version":"build-2784847793"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Vitamin B12 deficiency is seen in countries like India mainly because of predominantly vegetarian diet and is a significant health problem. Patients present with various neurological and hematological manifestations of megaloblastic anemia. In this case report, we present a 14-year-old girl child having a history of past blood transfusions and iron deficiency anemia currently presenting with severe anemia due to idiopathic autoimmune hemolytic anemia (AIHA) and later found to have concomitant vitamin B12 deficiency. On investigating, she had vitamin B12 deficiency, raised homocysteine and methylmalonic acid levels, positive Direct Coombs Test (DCT), and negative glucose-6-phoshphatase deficiency and osmotic fragility tests. Thyroid profile and tissue transglutaminase IgA (tTg-IgA) tests were negative. Antinuclear antibodies (ANA) and anti-double stranded DNA antibody (anti-dsDNA) serum immunoglobulin were also normal. Bone marrow showed megaloblastic anemia picture. Although AIHA and vitamin B12 deficiency anemia are not common, clinicians should have a high index of suspicion when patients present with hemolytic picture and severe megaloblastic anemia.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_401_20","type":"journal-article","created":{"date-parts":[[2020,7,26]],"date-time":"2020-07-26T10:08:40Z","timestamp":1595758120000},"page":"3756-3758","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Idiopathic autoimmune hemolytic anemia along with concomitant vitamin B12 deficiency in an adolescent girl: A rare occurrence"],"prefix":"10.4103","volume":"9","author":[{"given":"Kapil","family":"Bhalla","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Pt BD Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Pt BD Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv","family":"Nanda","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Pt BD Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pt BD Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuchi","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pt BD Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,7]]},"reference":[{"key":"R1-20260813","first-page":"1043","article-title":"Hemolysis and pancytopenia related vitamin B12 deficiency: A case report","volume":"4","author":"Sal","year":"2016","journal-title":"J Hematol Transfus"},{"key":"R2-20260813","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1365-2257.2006.00755.x","article-title":"Current hematological findings in cobalamin deficiency. A study of 201 consecutive patients with documented cobalamin deficiency","volume":"28","author":"Andr\u00e8s","year":"2006","journal-title":"Clin Lab Haematol"},{"key":"R3-20260813","doi-asserted-by":"crossref","first-page":"138","DOI":"10.5455\/annalsmedres.2019.10.672","article-title":"Autoimmune hemolytic anemia in children, 20 years experience of single center","volume":"27","author":"Karakurt","year":"2020","journal-title":"Ann Med Res"},{"key":"R4-20260813","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.tracli.2020.03.003","article-title":"Diagnosis and management of autoimmune hemolytic anemia in children","volume":"27","author":"Weli","journal-title":"Transfus Clin Biol"},{"key":"R5-20260813","doi-asserted-by":"crossref","first-page":"30","DOI":"10.22141\/2224-0551.15.1.2020.196755","article-title":"Problem of the diagnosis of acquired hemolytic anemia in childhood","volume":"15","author":"Nykytyuk","year":"2020","journal-title":"Childs Health"},{"key":"R6-20260813","doi-asserted-by":"crossref","first-page":"285","DOI":"10.4172\/2329-8790.1000285","article-title":"Hemolytic anemia an unusual presentation of vitamin B12 deficiency","volume":"6","author":"Cheema","year":"2018","journal-title":"J Hematol Thrombo Dis"},{"key":"R7-20260813","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/j.1600-0609.1990.tb00341.x","article-title":"Autoimmune cytopenias in pernicious anemia: A report of four cases and review of the literature","volume":"44","author":"Rabinowitz","year":"1990","journal-title":"Eur J Haematol"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_401_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:19:02Z","timestamp":1787843942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_401_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":7,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_401_20","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2020-03-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}