Vitamin B12 deficiency as a cause of severe neurological symptoms in breast fed infant – a case report
Open Access
- 30 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Italian Journal of Pediatrics
- Vol. 46 (1), 1-6
- https://doi.org/10.1186/s13052-020-0804-x
Abstract
Background Vitamin B12 (cobalamin, cbl) deficiency in children is rare and may occurs in exclusively breast fed infants of mothers on vegetarian or vegan diet with lack of appropriate supplementation. The clinical manifestation of vitamin B12 deficiency include neurological disorders, megaloblastic anemia and failure to thrive. Routine and commonly used laboratory tests such as cell blood count (CBC) or serum vitamin B12 level are sufficient for appropriate diagnosis. Typical therapy is based on intramuscular cobalamin injections. Early diagnosis and early onset of treatment are crucial factors for long-term prognosis of patients as the duration of deficiency may be correlated with the development of long lasting changes in the nervous system. The purpose of this article is to present influence of maternal vitamin B12 deficiency as a cause of infant psychomotor retardation. Case presentation We report the case of a 7 months old girl whose parents sought medical advice due to pathological somnolence and developmental regression of their daughter with onset approximately 2 months prior to the visit. Following several diagnostic tests it was determined that the infant’s symptoms were due to vitamin B12 deficiency which was secondary to the mother’s latent Addison-Biermer disease. Apart from neurological symptoms the infant also showed megaloblastic anemia which is typical to cobalamin deficiencies. Intramuscular vitamin B12 supplementation resulted in instant improvement of the patient’s general condition and blood morphology. Unfortunately, psychological examination indicated long-term psychomotor retardation due to delayed diagnosis of B12 deficiency. Conclusions Vitamin B12 levels should be considered during differential diagnosis of neurological symptoms in exclusively breast-fed infants especially if they co-exist with megaloblastic anemia and psychomotor retardation.Keywords
This publication has 25 references indexed in Scilit:
- The multi-faceted basis of vitamin B12 (cobalamin) neurotrophism in adult central nervous system: Lessons learned from its deficiencyProgress in Neurobiology, 2009
- Neuro-regression in vitamin B12 deficiencyBMJ Case Reports, 2009
- Clinical manifestations of infants with nutritional vitamin B12deficiency due to maternal dietary deficiencyActa Paediatrica, 2009
- Experimental and clinical evidence of the role of cytokines and growth factors in the pathogenesis of acquired cobalamin-deficient leukoneuropathyBrain Research Reviews, 2008
- Common Metabolic Profile in Infants Indicating Impaired Cobalamin Status Responds to Cobalamin SupplementationPEDIATRICS, 2008
- Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanismsNutrition Reviews, 2008
- The cellular prion protein (PrPC): Its physiological function and role in diseaseBiochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 2007
- Degeneration of skeletal muscle, peripheral nerves, and the central nervous system in transgenic mice overexpressing wild-type prion proteinsCell, 1994
- Folate-dependent 1-carbon transfer to biogenic amines mediated by methylenetetrahydrofolate reductaseNature, 1975
- Abnormal Fatty Acid Metabolism in Peripheral Nerves of Patients with Pernicious AnemiaJCI Insight, 1973