Vitamin B12 deficiency symptoms can include dyspnea and ‘profound’ fatigue

“On day four, ADAMTS13 (a gene that makes the enzyme that is involved in regulating blood clotting) activity results came back normal at 61 percent.”

Due to these results the hospital halted treatment for thrombotic microangiopathy.

“Accordingly, plasmapheresis was discontinued, parenteral B12 replacement was continued and that resulted in gradual improvement and eventually cessation of hemolysis and normalisation of haemoglobin and platelets,” it said.

“An early and accurate diagnosis of pseudo-thrombotic microangiopathy has a critical clinical impact with respect to administering the correct treatment with vitamin B12 replacement and avoiding, or shortening the duration of, unnecessary therapy with plasmapheresis.”