Low cobalamin levels associated with sickle cell disease: Contrasting origins and clinical meanings in two instructive patients.

摘要

A 24-year-old black man with hemoglobin SC was hospitalized in 2003 because of a 5-day history of fever, headache, and diffuse joint pains; a longer history of tiredness; and an unexplained 30-lb weight loss in the past year. He had been minimally symptomatic all his life, other than one presumed crisis with pneumonia at the age of 12 years. In 2002 and 2003, however, he required hospitalization and antibiotics elsewhere twice for presumed crises with pneumonia. He was taking no medications other than daily folic acid and denied drug or alcohol abuse.