@article{Kaya_Duman_Kahveci_Basaran_Aktas_2022, title={An Exceptional Case of Cobalamin Deficiency that Presented with Extremely High Indirect Bilirubin Levels}, volume={7}, url={https://ojs.njhsciences.com/index.php/njhs/article/view/316}, abstractNote={<p>Cobalamin deficiency anemia is a type of anemia that present with weakness, fatigue, icteric sclera and neuropathy. Main causes of<br>cobalamin deficiency are low intake or decreased absorption (gastric and intestinal causes). In present case, we report a 65-year-old male who<br>presented to the emergency department with signs and symptoms of cobalamin deficiency including bilateral peripheral neuropathy, icteric skin<br>and sclera, and abdominal pain in right upper quadrant. He had low cobalamin and extremely high bilirubin levels (8mg/dL) in serum. After<br>the diagnosis of cobalamin deficiency established, 1mg daily cobalamin treatment initiated for five days which would follow weekly and<br>monthly intramuscular injections consequently. Hemolysis and other causes of elevated indirect bilirubin levels were excluded in differential<br>diagnosis. Clinical and laboratory improvements were achieved after the treatment. In conclusion, physicians should kept in mind cobalamin<br>deficiency even in subjects with unusual high levels of indirect bilirubin.</p>}, number={2}, journal={National Journal of Health Sciences}, author={Kaya, Hamza and Duman, Tuba Taslamacioglu and Kahveci, Gizem and Basaran, Elif and Aktas, Gulali}, year={2022}, month={Jun.}, pages={96-97} }