Transcobalamin deficiency - a rare genetic defect in transportation of cobalamin; case report

Ann Hematol. 2024 Aug;103(8):3243-3246. doi: 10.1007/s00277-024-05878-7. Epub 2024 Jul 8.

Abstract

Background: Vitamin B12 is primarily transported from plasma to cells by Transcobalamin. Deficiency of Transcobalamin is a rare autosomal recessive disorder that results in unavailability of cobalamin in cells and accumulation of homocysteine and methylmalonic acid.

Case report: We report a case of a 2-year-old male child with persistent pancytopenia, recurrent infections, and megaloblastic anemia. Next-generation sequencing identified a novel variant in exon 8 of TCN2 gene. Substantial improvement has been observed following administration of high doses of parenteral methylcobalamin.

Conclusion: In patients with unresolved pancytopenia and megaloblastic anemia, Transcobalamin deficiency should be investigated and treated promptly to prevent any irreversible and harmful outcome.

Keywords: Megaloblastic anemia; Next generation sequencing; Pancytopenia; Transcobalamin II deficiency; Vitamin B12.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Megaloblastic / drug therapy
  • Anemia, Megaloblastic / genetics
  • Child, Preschool
  • Exons
  • Humans
  • Male
  • Pancytopenia / etiology
  • Pancytopenia / genetics
  • Transcobalamins* / deficiency
  • Transcobalamins* / genetics
  • Vitamin B 12 Deficiency / drug therapy
  • Vitamin B 12 Deficiency / genetics
  • Vitamin B 12* / therapeutic use

Substances

  • Transcobalamins
  • Vitamin B 12
  • TCN2 protein, human