Thrombotic thrombocytopenia purpura (TTP) is a hematological emergency that requires rapid assessment followed by prompt initiation of therapy due to high mortality associated with delayed treatment. TTP has many causes including heritable syndromes, ADAMTS13 deficiency, and drugs-related etiologies. Profound vitamin B12 deficiency can, in rare cases, mimic TTP in presentation, and since plasmapheresis can be of limited benefit, prompt diagnosis is necessary for accurate treatment with B12. Therefore, careful analysis of all clinical signs, symptoms, and labs must be assessed. We report a patient who presented with a diagnosis of TTP, and repeat assessment confirmed a diagnosis of sever vitamin B12 (B12) deficiency with pancytopenia who was appropriately treated with B12.

中文翻译：

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罕见的血栓性血小板减少性紫癜（TTP-）综合征，维生素B12缺乏症的原因：对重要病理结果的解释。

血栓性血小板减少性紫癜（TTP）是一种血液学紧急情况，由于与延误治疗相关的高死亡率，因此需要快速评估，然后迅速开始治疗。TTP有许多原因，包括遗传综合征，ADAMTS13缺乏症以及与药物相关的病因。在极少数情况下，严重的维生素B12缺乏症可模仿患者的TTP表现，并且由于血浆置换的益处有限，因此对B12进行准确治疗必须迅速诊断。因此，必须评估所有临床体征，症状和实验室的仔细分析。我们报告一名患者，该患者被诊断为TTP，并且重复评估证实了对全血细胞减少症的严重维生素B12（B12）缺乏症的诊断，并对其进行了适当的B12治疗。