A Rare Cause of Thrombotic Thrombocytopenia Purpura- (TTP-) Like Syndrome, Vitamin B12 Deficiency: Interpretation of Significant Pathological Findings

Table 2

Case reports of severe vitamin B12 presenting with findings similar to TTP. Cases are organized by age of patient, clinical symptoms at time of presentation, treatment, and outcomes.

Manuscript	Age	Presentation	Treatment	Outcome
Rodrigues et al. [4]	10-month-old F	Two weeks of intermittent vomiting, poor feeding, and decrease in weight percentile from 50% to 5%. Marked pallor, slightly jaundiced appearance, and mild dehydration	Red blood cells transfusion, cyanocobalamin (50 μg subcutaneously, five doses; 100 μg, oral, per day for 1 month), folic acid (5 mg/day), and food diversification	Biochemical and hematologic remission after 1 week and 1 month, respectively. Infant development normalized at 24 months
Tadakamalla et al. [5]	31 yo F	One month of generalized fatigue and bilateral paresthesias of the feet for one week	Plasmapheresis for 4 days followed by IM vitamin B12	B12 def 2/2 pernicious anemia. Complete biochemical response and resolution of symptoms at 4 months
Routh and Koenig [6]	43 yo M	Two-week history of confusion, fever, dyspnea, dizziness, and fatigue associated with diarrhea and hematochezia	3 units FFP, plasmapheresis IM B12	Not reported
Podder et al. [7]	46 yo M	One day history of hematuria and hemoptysis	Plasmapheresis 24 units FFP	Resolution of biochemical parameters. Acquired TTP in the setting of pernicious anemia
Chhabra et al. [8]	52 yo M	Fatigue, loose stools, and weight loss for six months	Intermuscular vitamin B12	Hematological resolution of anemia
Walter et at. [9]	77 yo F	Altered mental status, renal insufficiency, and thrombocytopenia	Plasmapheresis IM vitamin B 12 for life	Resolution of clinical symptoms and anemia 3 weeks after discharge
Merino and Cid [10]	36 yo M	3-4 weeks of asthenia in addition to fatigue and conjunctival pallor	IM vitamin B12 for life	Resolution of clinical and biochemical parameters
Trubin et al. [11]	41 yo F	Two months of fatigue	IM vitamin B12 for 10 days	Resolution of symptoms and correction of anemia
Chapuis et al. [12]	52 yo M	14 days of shortness of breath, general weakness, weight loss, and a sore tongue	2 units pRBCs IM vitamin B12 for life	Resolution of biochemical parameters 9 days after therapy. Resolution of symptoms 6 months after therapy