Vitamin B(12)-responsive pancytopenia mimicking myelodysplastic syndrome.
This study presents 12 patients (7 women and 5 men) with vitamin B(12)-responsive pancytopenia who had discordant laboratory findings and were misdiagnosed as having myelodysplastic syndrome (MDS). The median hemoglobin level was 6.5 g/dl, and the leukocyte and platelet counts were 2.85 × 10(9)/l and 55.5 × 10(9)/l, respectively. The median serum lactate dehydrogenase level was high (3,204.5 IU/l). The serum vitamin B(12) levels were within normal limits at the initial evaluation, but a serial follow-up of the vitamin B(12) levels revealed either fluctuations or a gradual decrease. The patients were initially diagnosed with MDS and responded rapidly to a 7-day parenteral B(12) treatment with normal complete blood counts (CBCs). We propose that patients suspected to have MDS may suffer from vitamin B(12) deficiency and that this can be revealed by a normalization of CBCs following 7 days of treatment with parental vitamin B(12).
Department of Laboratory Medicine, Catholic Blood and Marrow Transplantation Center, The Catholic University of Korea College of Medicine, Seoul, Korea.
Myungshin
M
Kim
Sung-Eun
SE
Lee
Joonhong
J
Park
Jihyang
J
Lim
Byung-Sik
BS
Cho
Yoo-Jin
YJ
Kim
Hee-Je
HJ
Kim
Seok
S
Lee
Chang-Ki
CK
Min
Yonggoo
Y
Kim
Seok-Goo
SG
Cho
D001772:Blood Cell Count; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy; D010198:Pancytopenia / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000188:drug therapy*
D014805:Vitamin B 12