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Table 1 Comparison of four similar unusual cases of pseudothrombotic thrombocytopenic purpura caused by vitamin B12 deficiency presenting with renal failure and a lack of macrocytosis

From: Vitamin B12 deficiency-induced pseudothrombotic microangiopathy without macrocytosis presenting with acute renal failure: a case report

Clinical characteristics Patients series (Author and reference)
Present case report Kandel et al. [12] Walter et al. [13] Dalsania et al. [14] Garderet et al. [15]
Gender/Age M/46 F/86 F/77 M/48 M/38
Hemoglobin (g/L)
[140–180]
36 32 55 50 45
MCV (fl)
[80–99]
87 127 120 80.2 90
WBC/neutrophil (× 109/L)
[4–11/1.5–7.5]
2.52/0.59 6.5/− 5.9/− 6.3/− 2.2/−
Platelets (×  109/L)
[140–440]
46 59 40 38 5
Creatinine (μmol/L)
[59–103]
176.8 168 300.6 97.2 Normal
Corrected reticulocyte count/Absolute reticulocyte count (× 109/L)
[0.5–2/25–75]
0.18/8.7 1.6/− 1.2/− 0.23/13 −/10
Schistocytosis Present Present Present Present Present
LDH (μkat/L)
[2.25–3.76]
24.6 118.2 66.5 150.1 323.7
Total/direct bilirubin (μmol/L)
[<  24/< 5.1]
17.1/− 63.3/17.1 20.5/5.1 205.3/85.5
Haptoglobin (mg/L)
[300–2000]
<  1 140 Undetectable <  100 <  100
Coombs test Negative Negative Negative Negative Negative
Serum B12 (pmol/L)
[145–569]
<  36.9 28 Undetectable 352.7 Undetectable
Methylmalonic acid level (μmol/l)
[0–0.4]
Not performed 0.753 Not performed 25,417 Not performed
Neurological symptoms None Present Present None None
TPE NO NO YES YES YES
  1. F female, LDH lactate dehydrogenase, M male, MCV mean corpuscular volume, TPE therapeutic plasma exchange, WBC white blood cells