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Conclusion This case underscores the diagnostic complexity in distinguishing true TMA from its mimics, particularly PTMA secondary to vitamin B12 deficiency

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The technique of first choice is MVD, especially in patients in whom neurovascular compression is identified

This is important for severe anemia or neurological problems

During pregnancy, the body needs more nutrients for fetal development

The observation of reticulocytosis which usually occurs between the third and tenth day of therapy confirms the diagnosis of vitamin B12 deficiency