Pulmonary embolism and megaloblastic anemia: is there a link
Many factors have been associated with venous thromboembolism. Among them, vitamin B12 deficiency can produce elevated homocysteine levels, which is a risk factor for venous embolism, since the latter interferes with the activation of Va coagulation factor by activation of C protein.

Published in the Radiology Case Reports, the authors present a case of a patient with metabolic syndrome with apparently unprovoked pulmonary embolism.

After careful evaluation, megaloblastic anemia was detected. Even though the patient had biochemistry findings of hemolysis and blood smear did not showed fragmented erythrocytes, which is consistent with pseudo-microangiopathic hemolytic anemia.

Lessons to be learnt:-
- B12 deficiency should be systematically considered as a potential cause of thrombotic events, especially in the context of a patient with risk factors for endothelial dysfunction.

- Homocysteine levels are not useful in follow-up, but can help to guide the therapy in an individualized way.

Read about the case in detail here: https://pxmd.co/nQuIu
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