LEMMO Integrated Cancer Care Inc.

Aug

2004

Anemia mimicks acute leukemiaDr. Lemmo Health Briefs, August 2004.

In a recent paper published in the Southern Medical Journal, vitamin B12 deficiency appeared to cause profound alterations in the bone marrow to give a false presentation of leukemia in two case reports. The authors commented that the alterations can mimic the more serious diagnosis of acute leukemia. The two patients described in this report were originally suspected of having acute myelogenous leukemia or myelodysplasia on the basis of the bone marrow results, and chemotherapy was considered. However, after further evaluation, they were both found to have vitamin B12 deficiency, and after giving vitamin B12 the bone marrow became normal.

Dr. Lemmo's Comments

It is surprising to see how a simple vitamin B12 deficiency could present as a severe form of leukemia. It makes one wonder how common such cases do occur in the general population and more disturbing how often such cases may be wrongly miss-diagnosed ( for B12 deficiency) and treated as a leukemia (i.e. AML, MDS). It may be prudent in such leukemic cases that, besides testing for a B12 deficiency problem, patients should be given an aggressive treatment of vitamin B12 (daily injections) just in case. In private practice, I have observed that the standard testing for vitamin B12 deficiency is not always performed (i.e. intrinsic factor antibodies) and not always reliable a side from the more classic symptoms a patient may present with (i.e. pernicious anemia). It is important to emphasize that a person can be low in vitamin B12 and NOT show any signs of anemia! Consequently, giving vitamin B12 injections and erroring on the side of caution (and missing a B12 deficiency) could considered a clinically prudent and safe approach.

References

South Med J. 2004 Mar; 97(3):295-7.