Severe vitamin B12 deficiency resulting in pancytopenia, splenomegaly and leukoerythroblastosis

European Journal of Haematology

Volumn 80, Issue 5, 2008, Pages 448-451

  Halfdanarson, Thorvardur R ^a,c   Walker, James A ^b   Litzow, Mark R ^a   Hanson, Curtis A ^a  

^a Mayo Clinic College of Medicine   (United States)

^b Mayo Health System   (United States)

^c UNIVERSITY OF IOWA HOSPITALS AND CLINICS   (United States)

Author keywords

B12 deficiency; Leukoerythroblastosis; Pancytopenia; Pernicious anemia; Splenomegaly

Indexed keywords

CYANOCOBALAMIN;

ADULT; ARTICLE; BLOOD CELL COUNT; BLOOD SMEAR; BONE MARROW EXAMINATION; CASE REPORT; CLINICAL FEATURE; CYANOCOBALAMIN DEFICIENCY; FEMALE; FOLLOW UP; HUMAN; MEGALOBLASTIC ANEMIA; MYELOPHTHISIC ANEMIA; PANCYTOPENIA; PHYSICAL EXAMINATION; PRIORITY JOURNAL; SPLENOMEGALY; VITAMIN BLOOD LEVEL;

ANEMIA, MYELOPHTHISIC; BIOPSY; FEMALE; HUMANS; MIDDLE AGED; PANCYTOPENIA; SPLENOMEGALY; VITAMIN B 12 DEFICIENCY;

EID: 41849097754     PISSN: 09024441     EISSN: 16000609     Source Type: Journal    
DOI: 10.1111/j.1600-0609.2008.01043.x     Document Type: Article

References (28)

1. Andres E, Vidal-Alaball J, Federici L, Loukili NH, Zimmer J, Kaltenbach G. Clinical aspects of cobalamin deficiency in elderly patients. Epidemiology, causes, clinical manifestations, and treatment with special focus on oral cobalamin therapy. Eur J Intern Med 2007 18 : 456 62.
2. Wickramasinghe SN. Diagnosis of megaloblastic anaemias. Blood Rev 2006 20 : 299 318.
3. Toh BH, van Driel IR, Gleeson PA. Pernicious anemia. N Engl J Med 1997 337 : 1441 8.
4. Andres E, Loukili NH, Noel E, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ 2004 171 : 251 9.
5. Andres E, Goichot B, Schlienger JL. Food cobalamin malabsorption: a usual cause of vitamin B12 deficiency. Arch Int Med 2000 160 : 2061 2.
6. Andres E, Affenberger S, Vinzio S, et al. Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. Am J Med 2005 118 : 1154 9.
7. Halfdanarson TR, Litzow MR, Murray JA. Hematologic manifestations of celiac disease. Blood 2007 109 : 412 1.
8. Klee GG. Cobalamin and folate evaluation: measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Clin Chem 2000 46 : 1277 83.
9. Snow CF. Laboratory diagnosis of vitamin B12 and folate deficiency: a guide for the primary care physician. Arch Int Med 1999 159 : 1289 98.
10. Ward PC. Modern approaches to the investigation of vitamin B12 deficiency. Clin Lab Med 2002 22 : 435 45.
11. Carmel R. Pernicious anemia. The expected findings of very low serum cobalamin levels, anemia, and macrocytosis are often lacking. Arch Int Med 1988 148 : 1712 4.
12. Stabler SP, Allen RH, Savage DG, Lindenbaum J. Clinical spectrum and diagnosis of cobalamin deficiency. Blood 1990 76 : 871 81.
13. Andres E, Affenberger S, Zimmer J, et al. Current hematological findings in cobalamin deficiency. A study of 201 consecutive patients with documented cobalamin deficiency. Clin Lab Haematol 2006 28 : 50 6.
14. MacCarty WC. Chronic splenomegaly. Arch Intern Med 1928 41 : 536 48.
15. Davidson S. Clinical picture of pernicious anaemia prior to introduction of liver therapy in 1926 and in Edinburgh subsequent to 1944. Br Med J 1957 1 : 241 3.
16. Bigg E. Spleen size in pernicious anemia. Ann Int Med 1940 14 : 277 80.
17. Osler W. Anæmia. In : Osler W, ed. The Principles and Practice of Medicine, Vol. 1, 8th edn. New York : D. Appleton and Company 1918 : 727 41.
18. Pruthi RK, Tefferi A, Petitt RM. Reversible marked splenomegaly in pernicious anemia. Ann Intern Med 1993 119 : 1053.
19. Vaughan JM. Leuco-erythroblastic anaemia. J Pathol Bacteriol 1936 42 : 541 64.
20. Byard RW, Bormanis J, Jones TG. Leukoerythroblastosis: a much maligned phenomenon? CMAJ 1987 137 : 191 2.
21. Wintrobe M. Clinical Hematology, 6th edn. Philadelphia : Lea & Febiger, 1967.
22. Clifford GO. The clinical significance of leukoerythroblastic anemia. Med Clin North Am 1966 50 : 779 90.
23. Scwartz SO, Stansbury F. Significance of nucleated red blood cells in peripheral blood: analysis of 1,496 cases. JAMA 1954 154 : 1339 40.
24. Retief FP. Leuco-Erythroblastosis in the Adult. Lancet 1964 1 : 639 42.
25. Burkett LL, Cox ML, Fields ML. Leukoerythroblastosis in the adult. Am J Clin Pathol 1965 44 : 494 8.
26. Budmiger H, Graf C, Streuli RA. Das leukoerythroblastäre Blutbild: Inzidenz und klinische Bedeutung (The leukoerythroblastic blood picture. Incidence and clinical significance). Schweiz Rundsch Med Prax 1984 73 : 1489 93.
27. Weick JK, Hagedorn AB, Linman JW. Leukoerythroblastosis. Diagnostic and prognostic significance. Mayo Clin Proc 1974 49 : 110 3.
28. Okpara RA. The prognostic significance of leukoerythroblastic anaemia in Nigerians. East Afr Med J 1985 62 : 185 8.