Abstract

The classic findings of vitamin B12 deficiency include anemia and neurologic symptoms. Elevation of liver enzymes is an atypical finding of this deficiency. In this case report, we present a ten-year-old male with pancytopenia due to vitamin B12 deficiency which was associated with elevated transaminases. Extensive work-up was completed to find a cause for this transaminitis with unremarkable results. Liver enzyme levels normalized with aggressive intramuscular vitamin B12 supplementation, suggesting a direct correlation.