Hypotension: an unusual presentation of vitamin B12 deficiency, with complete recovery following cyanocobalamin therapy

Vitamin B 12 deficiency and its sequelae are well described and reported, especially in vegetarians. However, its association with haemodynamic instability is not well identified. We report a case of a young man, previously healthy, presenting with fever, hypotension requiring vasopressors and pancytopenia. Extensive workup was unrevealing for possible infective, inflammatory or endocrine causes except for vitamin B 12 deficiency. Fever and haematological parameters stabilised after adequate supplementation of cyanocobalamin (vitamin B 12). - BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. Scopus