Case Report
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TEDAVİ SONRASI HIZLI NÖROLOJİK DÜZELME GÖRÜLEN VİTAMİN B12 EKSİKLİĞİ OLGUSU

Year 2020, Volume: 34 Issue: 1, 67 - 71, 07.04.2020
https://doi.org/10.5505/deutfd.2020.43660

Abstract

B12 vitamini eksikliği birçok farklı klinik belirtiyle ortaya çıkar. Eksikliği hematolojik, nörolojik, gastrointestinal, dermatolojik ve kardiyak bulgulara neden olabilir. B12 vitamini eksikliği, vejeteryan anne bebeklerinde ve gelişmekte olan ülkelerde yeterli miktarda B12 vitamini içeren besinlere erişimi olmayan bebeklerde daha kolay gelişir. Uzun süreli eksikliğinde bebeklerde sinirlilik, ilgisizlik, iştahsızlık ve gelişimsel gecikme görülebilir. Bu yazıda süt çocuğunda hipotonisite ve büyüme geriliği ile ortaya çıkan, tedavinin ardından nörolojik bulguları hızla düzelen bir B12 vitamini eksikliği olgusu sunulmuştur.

References

  • Serin HM, Kara AO, Oğuz B. West syndrome due to vitamin B12 deficiency. Turk Pediatri Ars. 2015;50:251-3.
  • Bhattacharjee A, Easo Samuel A. Vitamin B12 Deficiency in a Patient Presenting with Dyspnea: A Case Report. Adv J Emerg Med. 2018;17;3:e19.
  • Kocaoglu C, Akin F, Caksen H, Böke SB, Arslan S, Aygün S. Cerebral atrophy in a vitamin B12-deficient infant of a vegetarian mother. J Health Popul Nutr. 2014;32:367-71.
  • Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008;29:126-31.
  • Selinger E, Kühn T, Procházková M, Anděl M, Gojda J. Vitamin B12 Deficiency Is Prevalent Among Czech Vegans Who Do Not Use Vitamin B12 Supplements. Nutrients. 2019;11(12). pii: E3019.
  • Healton EB, Savage DG, Brust JC, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 1991; 70:229-45.
  • Monsen AL, Refsum H, Markestad T, Ueland PM. Cobalamin status and its biochemical markers methylmalonic acid and homocysteine in different age groups from 4 days to 19 years. Clin Chem. 2003; 49:2067-75.
  • Irevall T, Axelsson I, Naumburg E. B12 deficiency is common in infants and is accompanied by serious neurological symptoms. Acta Paediatr 2017;106:101-4.
  • Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood. 2017;129:2603-11.
  • Oberley MJ, Yang DT. Laboratory testing for cobalamin deficiency in megaloblastic anemia. Am J Hematol. 2013;88:522-6.
  • Savage DG, Lindenbaum J, Stabler SP, Allen RH. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994;96:239-46.
  • Stredny CM, Frosch O, Singhi S, Furutani E, Durbin AD, Grace RF, et al. Vitamin B12 Deficiency Presenting with Neurological Dysfunction in an Adolescent. Pediatr Neurol. 2016;62:66–70.
  • Goraya JS, Kaur S, Mehra B. Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. J Child Neurol. 2015;30:1831-7.
  • Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008;66:250-5.
  • Von Schenck U, Bender-Götze C, Koletzko B. Persistence of neurological damage induced by dietary vitamin B-12 deficiency in infancy. Arch Dis Child. 1997;77:137-9.
  • Stabler SP. Clinical practice. Vitamin B12 deficiency N Engl J Med. 2013;368:149-60.
  • Carmel R, Watkins D, Rosenblatt DS. Megaloblastic anemia. In: Nathan and Oski's hematology and oncology of infancy and childhood, 8th ed, Orkin SH, Fisher DE, Ginsburg D, et al (Eds), Elsevier Saunders, Philadelphia 2015. Vol 1, p.308.
  • Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study. Clin Ther. 2003;25:3124-34.
  • Butler CC, Vidal-Alaball J, Cannings-John R, McCaddon A, Hood K, Papaioannou A, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. Fam Pract. 2006;23:279-85.

A case of vitamin B12 deficiency with rapid neurological improvement after treatment

Year 2020, Volume: 34 Issue: 1, 67 - 71, 07.04.2020
https://doi.org/10.5505/deutfd.2020.43660

Abstract

Vitamin B12 deficiency presents with many different clinical manifestations. Its deficiency may cause hematological, neurological, gastrointestinal, dermatological and cardiac findings. Vitamin B12 deficiency develops easier in infants of vegetarian mothers and infants those not having an access to foods containing enough vitamin B12 in the developing countries. In its long-term deficiency, irritability, apathy, loss of appetite and developmental delay may occur in the infant. In this report, we present an infant of vitamin B12 deficiency with a history of hypotonicity and growth retardation. We wanted to draw attention to the rapidly recovering neurological findings of this patient who responded quickly to treatment.

References

  • Serin HM, Kara AO, Oğuz B. West syndrome due to vitamin B12 deficiency. Turk Pediatri Ars. 2015;50:251-3.
  • Bhattacharjee A, Easo Samuel A. Vitamin B12 Deficiency in a Patient Presenting with Dyspnea: A Case Report. Adv J Emerg Med. 2018;17;3:e19.
  • Kocaoglu C, Akin F, Caksen H, Böke SB, Arslan S, Aygün S. Cerebral atrophy in a vitamin B12-deficient infant of a vegetarian mother. J Health Popul Nutr. 2014;32:367-71.
  • Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008;29:126-31.
  • Selinger E, Kühn T, Procházková M, Anděl M, Gojda J. Vitamin B12 Deficiency Is Prevalent Among Czech Vegans Who Do Not Use Vitamin B12 Supplements. Nutrients. 2019;11(12). pii: E3019.
  • Healton EB, Savage DG, Brust JC, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 1991; 70:229-45.
  • Monsen AL, Refsum H, Markestad T, Ueland PM. Cobalamin status and its biochemical markers methylmalonic acid and homocysteine in different age groups from 4 days to 19 years. Clin Chem. 2003; 49:2067-75.
  • Irevall T, Axelsson I, Naumburg E. B12 deficiency is common in infants and is accompanied by serious neurological symptoms. Acta Paediatr 2017;106:101-4.
  • Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood. 2017;129:2603-11.
  • Oberley MJ, Yang DT. Laboratory testing for cobalamin deficiency in megaloblastic anemia. Am J Hematol. 2013;88:522-6.
  • Savage DG, Lindenbaum J, Stabler SP, Allen RH. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994;96:239-46.
  • Stredny CM, Frosch O, Singhi S, Furutani E, Durbin AD, Grace RF, et al. Vitamin B12 Deficiency Presenting with Neurological Dysfunction in an Adolescent. Pediatr Neurol. 2016;62:66–70.
  • Goraya JS, Kaur S, Mehra B. Neurology of Nutritional Vitamin B12 Deficiency in Infants: Case Series From India and Literature Review. J Child Neurol. 2015;30:1831-7.
  • Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008;66:250-5.
  • Von Schenck U, Bender-Götze C, Koletzko B. Persistence of neurological damage induced by dietary vitamin B-12 deficiency in infancy. Arch Dis Child. 1997;77:137-9.
  • Stabler SP. Clinical practice. Vitamin B12 deficiency N Engl J Med. 2013;368:149-60.
  • Carmel R, Watkins D, Rosenblatt DS. Megaloblastic anemia. In: Nathan and Oski's hematology and oncology of infancy and childhood, 8th ed, Orkin SH, Fisher DE, Ginsburg D, et al (Eds), Elsevier Saunders, Philadelphia 2015. Vol 1, p.308.
  • Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study. Clin Ther. 2003;25:3124-34.
  • Butler CC, Vidal-Alaball J, Cannings-John R, McCaddon A, Hood K, Papaioannou A, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. Fam Pract. 2006;23:279-85.
There are 19 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Studies
Authors

Dilek Subay This is me 0000-0002-5716-2938

Deniz Akça This is me 0000-0002-7987-3917

Sezin Akman This is me 0000-0002-6515-8066

Demet Alaygut This is me 0000-0002-2164-4652

Oya Halıcıoğlu This is me 0000-0002-0062-9138

Publication Date April 7, 2020
Submission Date August 19, 2019
Published in Issue Year 2020 Volume: 34 Issue: 1

Cite

Vancouver Subay D, Akça D, Akman S, Alaygut D, Halıcıoğlu O. A case of vitamin B12 deficiency with rapid neurological improvement after treatment. J DEU Med. 2020;34(1):67-71.