Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiency
Article first published online: 6 OCT 2008
©2008 The Author(s)/Journal Compilation ©2008 Foundation Acta Pædiatrica/Acta Pædiatrica
Volume 98, Issue 1, pages 98–102, January 2009
How to Cite
Zengin, E., Sarper, N. and Çakı Kılıç, S. (2009), Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiency. Acta Paediatrica, 98: 98–102. doi: 10.1111/j.1651-2227.2008.01059.x
- Issue published online: 9 DEC 2008
- Article first published online: 6 OCT 2008
- Received 26 June 2008; revised 6 August 2008; accepted 5 September 2008.
- Maternal dietary deficiency;
- Nutritional vitamin B12 deficiency
Aim: In developing countries, nutritional vitamin B12 deficiency in infants due to maternal diet without adequate protein of animal origin has some characteristic clinical features. In this study, haematological, neurological and gastrointestinal characteristics of nutritional vitamin B12 deficiency are presented.
Methods: Hospital records of 27 infants diagnosed in a paediatric haematology unit between 2000 and 2008 were evaluated retrospectively.
Results: The median age at diagnosis was 10.5 months (3–24 months). All the infants were exclusively breast fed and they presented with severe nonspecific manifestations, such as weakness, failure to thrive, refusal to wean, vomiting, developmental delay, irritability and tremor in addition to megaloblastic anaemia. The diagnosis was confirmed by complete blood counts, blood and marrow smears and serum vitamin B12 and folic acid levels. The median haemoglobin level was 6.4 g/dL (3.1–10.6) and mean corpuscular volume (MCV) was 96.8 fL (73–112.3). Some patients also had thrombocytopaenia and neutropaenia. All the infants showed clinical and haematological improvement with vitamin B12 administration. Patients with severe anaemia causing heart failure received packed red blood cell transfusions as the initial therapy.
Conclusion: Paediatricians must consider nutritional vitamin B12 deficiency due to maternal dietary deficiency in the differential diagnosis of some gastrointestinal, haematological, developmental and neurological disorders of infants with poor socioeconomic status. Delay in diagnosis may cause irreversible neurological damage.