Vitamin B12 has antioxidant properties, and the deficiency of vitamin B12 is associated with elevated inflammatory markers, which includes interleukin-6 (IL-6), malondialdehyde, and high sensitivity C-reactive protein.6 It is interesting that IL-6 in-vitro models revealed that it can be a direct catalytic inhibitor of ADAMTS13.7 Therefore, rarely the oxidative stress-induced IL-6 production in severe vitamin B12 deficiency can reduce ADAMTS13 activity, leading to the accumulation of unusually large multimers of von Willebrand factor causing platelet aggregation and thrombi. Here, VWF is linked to vitamin B12 deficiency.