What is it about?
Hyperpigmentation as a primary symptom is rare in vitamin B12 deficiency. This adolescent non-vegetarian girl presented with hyperpigmentation, anaemia, glossitis and weight loss. She was worked up to find out the cause of anaemia and hyperpigmentation. Addison disease was a strong provisional diagnosis. Her cortisol level was normal and megaloblastic anemia due to vitamin B12 deficiency was found. All of her symptoms were dramatically improved by injectable cobalamin. As vitamin B12 deficiency is a treatable condition it should be ruled out in patients presenting with hyperpigmentation. Early replacement therapy also prevents multisystem involvement like bone marrow failure and demyelinating neurological disease.
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Why is it important?
Hyperpigmentation is not a usual manifestation of Vitamin B12 deficiency. Addison's disease was initially considered due to the presence of hyperpigmentation and weight loss. This case serves as a reminder that even strong provisional diagnoses require comprehensive investigations to rule out other potential underlying causes. Early diagnosis and replacement therapy with cobalamin led to a rapid resolution of symptoms. This emphasizes the importance of identifying and treating vitamin B12 deficiency in its early stages to prevent multisystem complications
Perspectives
This case report contributes to the medical literature by shedding light on an uncommon presentation of vitamin B12 deficiency. It emphasizes the importance of considering atypical manifestations in the diagnostic process and showcases the impact of early intervention. This publication will likely benefit a wide range of healthcare professionals, including physicians, internists, endocrinologists, and haematologists, by increasing awareness about hyperpigmentation as a potential symptom of vitamin B12 deficiency. Moreover, it serves as a reminder of the need for early recognition and treatment to prevent further complications, thereby improving patient outcomes. By sharing this case, the publication underscores the significance of holistic diagnostic approaches and highlights the positive impact of timely therapeutic interventions.
Dr. Syeda Humaida Hasan
Chittagong Medical College
Read the Original
This page is a summary of: Hyperpigmentation with Vitamin B12 Deficiency in an Adolescent Girl, Journal of Bangladesh College of Physicians and Surgeons, November 2020, Bangladesh Journals Online (BanglaJOL),
DOI: 10.3329/jbcps.v39i1.50461.
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