Pseudo-Thrombotic Microangiopathy (Pseudo-TMA): a rare manifestation of vitamin B12 deficiency in a child

Vitamin B12 is vital for physiological functions, and its deficiency can manifest from mild symptoms to severe conditions. This case report discusses a rare presentation of Vitamin B12 deficiency as Pseudo-Thrombotic Microangiopathy (Pseudo-TMA) in an 11-year-old vegan child. Pseudo-TMA, marked by hemolytic anemia, thrombocytopenia, and schistocytosis, mimics thrombotic microangiopathy (TMA) and requires accurate diagnosis. A thorough history, examination, and targeted investigations revealed severe macrocytic anemia with pancytopenia. Macrocytic anemia with reticulocytopenia is a common form of megaloblastic anemia in developing countries. Management included stabilization with blood transfusion, parenteral vitamin B12, and oral multivitamins. The favorable response highlights the importance of clinical evaluation in diagnosing rare pediatric presentations and optimizing resource use.