Case Report
Severe Vitamin B12 Deficiency in Pregnancy Mimicking HELLP Syndrome
Table 1
Laboratory or treatment measures before and after delivery.
| Laboratory or Treatment Measure | Initial evaluation | Prior to delivery | PPD 1 | PPD 2 | PPD 3 | PPD4 | PPD5 | 21+4/7 weeks gestation | 21+5/7 weeks gestation |
| Hemoglobin (g/dl) | 11.0 | 9.7 | 8.4 | 9.0 | 9.5 | 8.8 | 9.3 | Platelet Count (k/μl) | 66 | 93 | 90 | 103 | 133 | 112 | 175 | Lactate dehydrogenase (U/L) | 985 | 872 | 706 | n/a | n/a | n/a | 404 | Alanine transaminase (U/L) | 20 | 14 | 24 | 12 | 12 | 13 | 15 | Aspartate transaminase (U/L) | 40 | 30 | 20 | 19 | 15 | 19 | 19 | Creatinine (mg/dl) | 0.7 | 0.9 | 0.9 | 0.6 | 0.8 | 0.8 | 0.8 | Haptoglobin (mg/dl) | <8 | n/a | <8 | <8 | n/a | n/a | n/a | Vitamin B12 (ρg/ml) | n/a | n/a | <146 | n/a | n/a | n/a | n/a | Vitamin B12 supplementation (subcutaneous injection) | n/a | n/a | 1000 mcg | 1000 mcg | 1000 mcg | 1000 mcg | 1000 mcg |
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PPD: postpartum day; n/a: not available. Normal ranges: Hemoglobin (11.6-15.4 g/dl); Platelet count (150-450 k/ μl); Lactate dehydrogenase (125-220); Alanine transaminase (0-55 U/L); Aspartate transaminase (5-34 U/L); Creatinine (0.6-1.1 mg/dl); Haptoglobin (30-200 mg/dl); Vitamin B12 (213-816 ρg/ml). |