Table 2.
Case reports of severe vitamin B12 presenting with findings similar to TTP. Cases are organized by age of patient, clinical symptoms at time of presentation, treatment, and outcomes.
| Manuscript | Age | Presentation | Treatment | Outcome |
|---|---|---|---|---|
| Rodrigues et al. [4] | 10-month-old F | Two weeks of intermittent vomiting, poor feeding, and decrease in weight percentile from 50% to 5%. Marked pallor, slightly jaundiced appearance, and mild dehydration | Red blood cells transfusion, cyanocobalamin (50 μg subcutaneously, five doses; 100 μg, oral, per day for 1 month), folic acid (5 mg/day), and food diversification | Biochemical and hematologic remission after 1 week and 1 month, respectively. Infant development normalized at 24 months |
| Tadakamalla et al. [5] | 31 yo F | One month of generalized fatigue and bilateral paresthesias of the feet for one week | Plasmapheresis for 4 days followed by IM vitamin B12 | B12 def 2/2 pernicious anemia. Complete biochemical response and resolution of symptoms at 4 months |
| Routh and Koenig [6] | 43 yo M | Two-week history of confusion, fever, dyspnea, dizziness, and fatigue associated with diarrhea and hematochezia | 3 units FFP, plasmapheresis IM B12 | Not reported |
| Podder et al. [7] | 46 yo M | One day history of hematuria and hemoptysis | Plasmapheresis 24 units FFP | Resolution of biochemical parameters. Acquired TTP in the setting of pernicious anemia |
| Chhabra et al. [8] | 52 yo M | Fatigue, loose stools, and weight loss for six months | Intermuscular vitamin B12 | Hematological resolution of anemia |
| Walter et at. [9] | 77 yo F | Altered mental status, renal insufficiency, and thrombocytopenia | Plasmapheresis IM vitamin B 12 for life | Resolution of clinical symptoms and anemia 3 weeks after discharge |
| Merino and Cid [10] | 36 yo M | 3-4 weeks of asthenia in addition to fatigue and conjunctival pallor | IM vitamin B12 for life | Resolution of clinical and biochemical parameters |
| Trubin et al. [11] | 41 yo F | Two months of fatigue | IM vitamin B12 for 10 days | Resolution of symptoms and correction of anemia |
| Chapuis et al. [12] | 52 yo M | 14 days of shortness of breath, general weakness, weight loss, and a sore tongue | 2 units pRBCs IM vitamin B12 for life | Resolution of biochemical parameters 9 days after therapy. Resolution of symptoms 6 months after therapy |