Jornal de Hematologia e Doenças Tromboembólicas
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Hemolytic Anemia an Unusual Presentation of Vitamin B12 Deficiency

Anmol Cheema, Joshua Bramson, Ravneet Bajwa, Mohammad A Hossain and Arif Asif

Vitamin B12, or cobalamin, is a water soluble vitamin which is synthesized by bacteria and archaea. Vitamin B12 is absorbed in the terminal ileum after binding intrinsic factor, a glycoprotein produced by the parietal cells in the stomach. The most common cause of B12 deficiency worldwide is pernicious anemia. Pernicious anemia is a deficiency of vitamin B12 due to lack of intrinsic factor. Usually, this is secondary to production of autoantibodies directed against the intrinsic factor of gastric parietal cells, leading to atrophic gastritis. Common findings in Vitamin B12 deficiency include anemia, leukopenia, and thrombocytopenia, macrocytosis, and hypersegmented neutrophils. Vitamin B12 deficiency is a rare cause of hemolytic anemia (approximately 1.5% of cases). Here, we present a case of a 59-year-old male found to have hemolytic anemia secondary to marked vitamin B12 deficiency and improved after vitamin supplementation and provide a brief review of literature.