A case of megaloblastic anemia simulating a cold autoimmune hemolytic anemia

Abstract

We report a case of pernicious anemia in which the first diagnosis suspicion was cold autoimmune hemolytic anemia (cAIHA) due to the presence of cold autoantibodies. A 47-year-old woman with a medical history of autoimmune thyroid disease came to the hospital with a clinical and serologic presentation of AIHA. However, because of determination of vitamin B12 (VB12) deficiency, she was finally diagnosed with megaloblastic anemia. In the acute period, the patient received short-term corticosteroid therapy and later VB12. The patient's hemoglobin level and general condition showed improvement. Immunohematology 2020;36:89-92.

Late‐onset refractory hemolytic anemia in siblings treated for methionine synthase reductase deficiency: A rare complication possibly prevented by hydroxocobalamin dose escalation?

“…It is compatible with megaloblastic anemia due to impaired B12 metabolism. Interestingly, it has been reported in Biermer's anemia or other B12 deficiency conditions, the occurrence of hemolytic anemia similar to our cases 23–25 …”

“…Interestingly, it has been reported in Biermer's anemia or other B12 deficiency conditions, the occurrence of hemolytic anemia similar to our cases. [23][24][25] Intramedullary hemolysis can be enhanced by parvovirus B19 (PVB19) which directly targets erythroblasts in the bone marrow by interacting with the highly expressed globoside (P antigen) on erythroid precursors. Indeed, replication of this erythrovirus ultimately leads to giant pro-erythroblasts that release infectious particles F I G U R E 2 Hemolysis laboratory parameters evolution over time and changes in hydroxocobalamin dosages.…”

“…Interestingly, it has been reported in Biermer's anemia or other B12 deficiency conditions, the occurrence of hemolytic anemia similar to our cases. 23 , 24 , 25 …”

A Case Report of Cold Agglutinin Disease, Severe B12 Deficiency, and Pernicious Anemia: A Deadly Coincidence

“…There also have been cases in which severe vitamin B 12 deficiency presents as CAD until further testing is performed, such as the case of De La Puerta et al [ 26 ], where the deficiency was mistaken as CAD given the presentation of hemolytic anemia with supportive laboratories markers, as well as with the case presented by Cikrikcioglu et al [ 27 ], where the vitamin B12 deficiency first presented as hemolysis anemia. However, their patient had thalassemia minor.…”