Vitamin B12 deficiency: The great masquerader

Authors

  • Sarah Dobrozsi MD,

    Corresponding author
    1. Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
    • Correspondence to: Sarah Dobrozsi, Department of Pediatrics, Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, 8701 Watertown Plank Road, MFRC 3075, Milwaukee, WI 53226.

      E-mail: sdobrozsi@mcw.edu

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  • Veronica H. Flood MD,

    1. Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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  • Julie Panepinto MD,

    1. Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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  • J. Paul Scott MD,

    1. Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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  • Amanda Brandow DO, MS

    1. Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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  • Conflict of interest: Nothing to declare.
  • Contributor's statement: Dr. Sarah Dobrozsi drafted the initial manuscript and all revisions. Drs. Veronica H. Flood, Julie Panepinto, and J. Paul Scott reviewed the manuscript, and approved the final manuscript as submitted. Dr. Amanda Brandow conceptualized the manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Abstract

Vitamin B12 deficiency is rare in children, with nonspecific symptoms including failure to thrive, vomiting, anorexia, and neurologic changes with or without hematologic disturbances. The neuropathy can be severe and irreversible. We report four cases of children with B12 deficiency secondary to adult type pernicious anemia, a presumed transport protein abnormality, and a metabolic defect. All demonstrated neurologic compromise that improved after initiation of B12 therapy. Hematologic manifestations may be preceded by constitutional, gastrointestinal, or neurologic changes, and must raise concern for B12 deficiency. Therapy should be initiated promptly in this setting to prevent irreversible neuropathy. Pediatr Blood Cancer 2014;61:753–755. © 2013 Wiley Periodicals, Inc.

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