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Volume 33, Issue 2, June 2022



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Mediterr J Rheumatol 2022;33(2):241-6
Co-existence of Thrombotic Thrombocytopenic Purpura and Megaloblastic Anaemia: A Case-Based Review
Authors Information

1Department of Internal Medicine, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India

2Department of Clinical Immunology & Rheumatology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India

3Department of Nephrology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India

4Department of Pathology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India

 

P. Gupta, S. Ahmed, N. K. Rout, C. Yelisetti, R. Panigrahi, P. K. Behera, K. P. Tripathy, S. S. Panda

Abstract

Introduction: Thrombotic thrombocytopenic purpura is a rare and fatal thrombotic microangiopathy characterised by a pentad of microangiopathic haemolytic anaemia, thrombocytopenia, renal abnormalities, neurological abnormalities, and fever. Due to ineffective erythropoiesis, vitamin-B12 deficiency may rarely present as haemolytic anaemia. Case report: We report a case of a 42-year-old vegetarian female presenting as vitamin B12 deficiency anaemia found to have concomitant TTP, responding to plasmapheresis, corticosteroids, and rituximab therapy. Discussion: In this case of vitamin B12 deficiency with co-existent TTP, we hypothesise vitamin B12 deficiency as a contributory or precipitating factor for TTP. We reviewed similar cases in the literature to support this hypothesis. Timely detection of TTP and the initiation of treatment is of utmost importance as TTP has a high mortality when left untreated. The possible relationship with Vitamin B12 deficiency needs further exploration.


Cite this article as: Gupta P, Ahmed S, Rout NK, Yelisetti C, Panigrahi R, Behera PK, Tripathy KP, Panda SS. Co-existence of Thrombotic Thrombocytopenic Purpura and Megaloblastic Anaemia: A Case-Based Review. Mediterr J Rheumatol 2022;33(2):241-6.

Article Submitted: 18 Dec 2020; Revised Form: 6 Apr 2021; Article Accepted: 20 Apr 2021; Available Online: 30 Jun 2022

https://doi.org/10.31138/mjr.33.2.241


This work is licensed under a Creative Commons Attribution 4.0 International License.

©Gupta P, Ahmed S, Rout NK, Yelisetti C, Panigrahi R, Behera PK, Tripathy KP, Panda SS.