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Thalassemia minor presenting with vitamin B12 deficiency, paraparesis, and microcytosis

Authors Lardhi A, Alhaj Ali R, Ali R, Mohammed T

Received 25 January 2018

Accepted for publication 29 May 2018

Published 4 September 2018 Volume 2018:9 Pages 141—144


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Martin Bluth

Arwa Lardhi,1 Rania Alhaj Ali,1 Rola Ali,2 Tarek Mohammed1

1Internal Medicine Department, Doctor Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 2An-Najah National University, Nablus, West Bank, Palestine

Abstract: Vitamin B12 is essential for proper neurological functioning, and its deficiency may cause a wide range of neuropsychiatric and hematological manifestations. We report a case of a previously healthy 32-year-old female who was admitted to our hospital with sudden onset of bilateral lower limb paraparesis and loss of sensation. The serum level of vitamin B12 was mildly decreased with high methylmalonic acid and homocysteine levels. However, her complete blood count showed no evidence of anemia or macrocytosis; instead, her mean corpuscular volume was low. Hemoglobin electrophoresis showed thalassemia trait, and that probably masked the megaloblastic features of vitamin B12 deficiency. She responded fully to vitamin B12 replacement therapy.

Keywords: thalassemia trait, microcytosis, pernicious anemia, paraparesis, cobalamin deficiency

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