Mediterranean Journal of Hematology and Infectious Diseases (Aug 2014)
Clinical Manifestations of Infants with Vitamin B12 Deficiency due to Maternal Deficiency
Abstract
Background: Human species does not synthesize vitamin B12. In developing countries, vitamin B12 deficiency in infants due to maternal diet without adequate protein of animal origin has some characteristic clinical and laboratory features. We report our cases that admitted to hospital with different clinical presentations by the need of hospitalization but have the diagnosis of vitamin B12 deficiency in follow-up and evaluation. Material and Methods: Hospital records of infants diagnosed with vitamin B12 deficiency between 2011 and 2013 were evaluated retrospectively. Results: A total of 22 patients were included with a mean age of 6.4 months. All of the mothers had vitamin B12 deficiency. All of the patients were fed with breast milk. Four of the patients’ (18.2%) weight and height were below the third percentile. The most common symptoms of the patients were as follows; infections in 8, pallor in 8, refuse to solid food or to suck in 4, failure to thrive in 4, fatigue in 3, hypotonia and neuro-developmental delay in 1, convulsions in 2, and vomiting in 1. Two of the patients had jaundice at admission and they got the diagnosis of hemolytic anemia as well. Six patients had the neurologic signs and symptoms. Anemia was found in 18/22 patients (81.8%). Three patients (13.6%) had leukopenia, 8 patients (36.4%) had neutropenia, 2 patients (9.1%) had thrombocytopenia. Cyanocobalamine was administered to all patients and mothers. After the treatment, all of patients’ clinical and laboratory findings were improved. Conclusions: Pediatricians must consider nutritional vitamin B12 deficiency due to maternal dietary deficiency in the differential diagnosis of some hematological, neurological, and gastrointestinal disorders of infants with poor socioeconomic status. Delay in diagnosis may cause irreversible neurological damage.
