Variable presentations of Vitamin B12 deficiency in Eastern India: A Case Series

Abstract

Vitamin B12 deficiency causes anemia with other hematological, neurological and systemic manifestations. Skin manifestations may also occur due to dietary deficiency in vegeterians. Acral hyperpigmentation occurring in distal parts of upper and lower limbs must be differentiated from Addison’s disease and vascular occlusion. The cases presented here showed acral hyperpigmentation( Case 1 and 3) which reversed following vitamin B12 therapy and the patient recovered. Case 2 showed anemia and symptoms reversing after vitamin B12 replacement. Leukopenia also reversed in case 3 following therapy.The importance of the case series lies in the fact that vitamin B12 deficiency may present not only with anemia and neurological manifestations, but also as acralhyperpigmentation which reverses following treatment.