How Much To Get?
Abstract
The array of diagnostic workup for pyrexia of unknown origin (PUO) generally revolves in searching for infections, inflammatory/autoimmune, and endocrine etiologies. A differential diagnosis of fever, hemolytic anemia, and thrombocytopenia can have etiologies varying from infections like malaria, dengue, cytomegalovirus, Ebstein barr virus, Parvovirus, infective endocarditis, to autoimmune disorder (systemic lupus erythromatosis), vasculitis, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura (TTP), autoimmune hemolytic anemia/Evan’s syndrome, paroxysmal nocturnal hemoglobinuri (PNH), or drugs. Severe vitamin B12 deficiency may cause fever and if accompanied by concurrent hyper-homocysteinemia and hypophosphatemia can sometimes lead to severe hemolysis mimicking the above-mentioned conditions.
We present a case that highlights vitamin B12 and vitamin D deficiency as an easily treatable cause of PUO, hemolytic anemia, and thrombocytopenia, which should be actively looked for and treated before proceeding with more complicated and expensive investigation or starting empiric treatments.
1. Fatigue
Your body’s cells need B12 to function properly. As such, having inadequate B12 levels can decrease normal red blood cell production, which can impair oxygen delivery Specifically, a deficiency in B12 or folate can cause megaloblastic anemia.
You Feel Tired And Drained
Even the best of us hits the snooze button now and then – but if you’re constantly tired, it could signal a nutrient deficiency. Correcting your B-12 levels should solve the problem, allowing your body to make healthy red blood cells again.