World Journal of Anemia

Register      Login

VOLUME 2 , ISSUE 1 ( January-March, 2018 ) > List of Articles


Vitamin B12 deficiency, a cause of Bicytopenia complicating Pregnancy

Nisha Bhatia, Krishna K Meka

Keywords : Bicytopenia, Complications in pregnancy, Severe anemia, Vitamin B12 deficiency

Citation Information : Bhatia N, Meka KK. Vitamin B12 deficiency, a cause of Bicytopenia complicating Pregnancy. World J Anemia 2018; 2 (1):39-40.

DOI: 10.5005/jp-journals-10065-0028

License: CC BY-ND 3.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: Bicytopenia in pregnancy is a rare entity that poses as a diagnostic challenge. It may present as a combination of anemia, leukopenia or thrombocytopenia. Though bone marrow failure is the commonest cause, nutritional deficiencies need to be ruled out. We report a case of Bicytopenia in pregnancy due to Vitamin B12 deficiency. Case report: A 22 year old primigravida with 29 weeks of gestation presented with severe anemia. On evaluation her haemoglobin was 5.1gm/dl and blood picture showed a mixed population of normocytes, hypochromic red blood cells with macrocytes; normal neutrophil count with hypersegmented neutrophils and diminished platelets. Iron studies were normal and her serum Vitamin B12 levels were low. She was given blood transfusions to improve her hemoglobin. Post transfusion, she set into spontaneous labor and delivered a dead female baby of wt 1kg. Treatment with injectable cyanocobalamin followed by oral multivitamin led to a sustained improvement in the haematological parameters. Discussion: This case demonstrates that B12 deficiency could be a rare cause of bicytopenia in pregnancy. Failure to diagnose and treat could lead to fatal maternal and fetal complications. Early diagnosis of B12 deficiency and supplementation is warranted.

PDF Share
  1. Zhang C, Liang MY, Wang SM. Clinical analysis of bicytopenia and pancytopenia during pregnancy. Zhonghua Fu Chan Ke Za Zhi 2009 Jul;44(7):488-491.
  2. Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol 2014 Aug;166(4):496-513.
  3. Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency. Haematologica 2006 Nov;91(11):1506-1512.
  4. Hudson B. 10 minute consultation: vitamin B12 deficiency. BMJ 2012 Jun;340:1245-1246.
  5. Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset SE, Orning L, Guttormsen AB, Joglekar A, Sayyad MG, Ulvik A, et al. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr 2001 Aug;74(2):233-241.
  6. Yusufji D, Mathan VI, Baker SJ. Iron, folate and Vitamin B12 nutrition in pregnancy: a study of 1000 women from Southern India. Bull World Health Organ 1973;48(1):15-22.
  7. Muthayya S, Kurpad AV, Duggan CP, Bosch RJ, Dwarkanath P, Mhaskar A, Mhaskar R, Thomas A, Vaz M, Bhat S, et al. Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians. Eur J Clin Nutr 2006 Jun;60(6):791-801.
  8. Idris N, Arsyad A. Vitamin B12 deficiency presenting as pancytopenia in pregnancy: a case report. Malays Fam Physician 2012 Aug;7(2-3):46-50.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.