Two unusual presentations of vitamin B12 Deficiency.

Vitamin B12, a water-soluble vitamin is important in DNA synthesis. Inadequate intake of animal foods and pernicious anaemia (loss of intrinsic factor due to autoimmune atrophic gastritis) are known to be the most common causes of severe deficiency worldwide (1). Although most of the patients with deficiency have only mild haematological findings, very few presents present with symptomatic pancytopenia, severe anaemia (haemaglobin <6 g/dL) leucoerythroblastic blood picture with haemolysis and organomegaly, mimicking haematological malignancy, as in patient A. Cutaneous manifestations including poor wound healing and hair changes could also be presenting complaints as in patient B. So in this case series we present two cases with uncommon clinical manifestations due to vitamin B12 deficiency and the marked clinical response with the adequate B12 replacement.