Thrombotic microangiopathies (TMA) involve a combination of hemolytic anemia, low platelet counts, and organ damage typically stemming from endothelial damage, but vitamin B12 deficiency can mimic this condition.
A 60-year-old woman presented with signs of severe illness, leading to a high-risk diagnosis of thrombotic thrombocytopenic purpura (TTP), but was later found to have a significant vitamin B12 deficiency, which explained her symptoms.
This case emphasizes that vitamin B12 deficiency can present like TTP, and clinicians should consider it as a potential cause of microangiopathic hemolytic anemia when specific lab results indicate low B12 levels and low reticulocyte counts, enabling