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Case Reports in Hematology
Volume 2015, Article ID 478151, 5 pages
http://dx.doi.org/10.1155/2015/478151
Case Report

Vitamin B12 Deficiency and Hemoglobin H Disease Early Misdiagnosed as Thrombotic Thrombocytopenic Purpura: A Series of Unfortunate Events

1Second Department of Internal Medicine, Aristotle University, Hippokration Hospital, 54642 Thessaloniki, Greece
2Thalassemia Unit, Hippokration Hospital, 54642 Thessaloniki, Greece
3Intensive Care Unit, Hippokration Hospital, 54642 Thessaloniki, Greece
4Fifth Surgical Clinic, Aristotle University, Hippokration Hospital, 54642 Thessaloniki, Greece

Received 11 July 2015; Revised 9 October 2015; Accepted 15 October 2015

Academic Editor: Uma Dasgupta

Copyright © 2015 Panagiotis Andreadis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We herein would like to report an interesting case of a patient who presented with anemia and thrombocytopenia combined with high serum Lactic Dehydrogenase where Thrombotic Thrombocytopenic Purpura was originally considered. As indicated a central venous catheter was inserted in his subclavian vein which led to mediastinal hematoma and finally intubation and Intensive Care Unit (ICU) hospitalization. After further examination patient was finally diagnosed with B12 deficiency in a setting of H hemoglobinopathy. There have been previous reports where pernicious anemia was originally diagnosed and treated as Thrombotic Thrombocytopenic Purpura but there has been none to our knowledge that was implicated with hemothorax and ICU hospitalization or correlated with thalassemia and we discuss the significance of accurate diagnosis in order to avoid adverse reactions and therapy implications.