Çocuklarda B12 Vitamini Eksikliği ve İlişkili Bulguların Sıklığı

Yıl 2022, , 503 - 508, 04.10.2022

Hilal Aydın , Oğuzhan Korkut , Ezgi Özden , Demet Can

https://doi.org/10.53424/balikesirsbd.1142063

Öz

Amaç: Bu çalışmanın amacı, çocuk nörolojisi polikliniğine çeşitli semptomlarla başvuran hastalarda vitamin B12 eksikliği ile ilişkili klinik bulguları belirlemek ve güncel literatür ışığında tartışmaktır. Gereç ve Yöntem: Bu retrospektif kesitsel çalışmaya 01.08.2019-01.08.2021 tarihleri arasında Balikesir Üniversitesi Tıp Fakültesi Çocuk Nöroloji Polikliniğine başvuran ve B12 vitamini düzeyi 250 ng/mL'nin altında olan 1 ay-18 yaş arası çocuklar dahil edildi. Bulgular: Çalışmaya 63 (%39.1) kadın ve 98 (%60.9) erkek 161 olgu dahil edildi. Hastaların yaş ortalaması 7.43±5.77 (0-17) yıl idi. Her iki cinsiyetteki hastaların büyük çoğunluğu 0-6 yaş grubundaydı. Vitamin B12 eksikliği olan hastaların %81.98'inde nörolojik bulgular, %18.02'sinde nörolojik olmayan bulgular mevcuttu. En sık görülen nörolojik bulgu nöromotor retardasyon (N=73, %45.34), ardından nöbetler (N=33, %20.50) idi. Tüm hastalarda ortalama B12 vitamini düzeyi 167.70±45.17 (58-250) pg/ml idi. B12 vitamini ve ferritin düzeyleri veya tam kan sayımı parametreleri [Hb, Htc ve MCV] açısından erkek ve kız çocukları arasında istatistiksel olarak anlamlı fark saptanmadı (sırasıyla p=0.428, p=0.646, p=0.110, p=0.128, p=0.864). Sonuç: Bu çalışma, sağlık çalışanları için hastalıkla ilişkili olarak karşılaştığımız klinik tablolar hakkında genel bir değerlendirme sunmaktadır.

Anahtar Kelimeler

B12 Vitamini, Çocuk, Eksiklik, Bulgu, Tedavi

Frequency of Vitamin B12 Deficiency and Associated Findings in Children

Öz

Objective: The purpose of this study was to determine clinical findings associated with vitamin B12 deficiency in patients presenting to the pediatric neurology department with various different symptoms and to discuss these in the light of the current literature. Materials and Methods: Children aged between one month and 18 years presenting to the Balikesir University Medical Faculty pediatric neurology clinic, Turkey, between 01.08.2019-01.08.2021 and with vitamin B12 levels lower than 250 ng/mL were included in this retrospective, cross-sectional study. Results: One hundred sixty-one cases were included in the study 63 (39.1%) female and 98 (60.9%) male. The patients’ mean age was 7.43±5.77 (0-17) years. The majority of patients of both genders were in the 0-6 age group. Neurological findings were present in 81.98% of patients with Vitamin B12 deficiency, and non-neurological findings in 18.02%. The most frequent neurological finding was neuromotor retardation (N=73, 45.34%), followed by seizures (N=33, 20.50%). The mean Vitamin B12 level among all the patients was 167.70±45.17 (58-250) pg/ml. No statistically significant difference was determined between boys and girls in terms of Vitamin B12 and ferritin levels or complete blood count parameters [Hb, Htc, and MCV] (respectively p=0.428, p=0.646, p=0.110, p=0.128, p=0.864). Conclusions: This study provides a general evaluation for health professionals regarding clinical presentations encountered by us in association with the disease.

Anahtar Kelimeler

Vitamin B12, Children, Treatment, Deficiency, Sign

Kaynakça

• Arslan, E.A. (2020). Neurological Findings of Vitamin B12 Deficiency in Children: Analysıs of 120 Patients. Acıbadem University Health Sciences Journal, 1, 83-88.
• Demir, N., Koc, A., Ustyol, L., Peker, E., & Abuhandan, M. (2013). Clinical and neurological findings of severe vitamin B12 deficiency in infancy and importance of early diagnosis and treatment. J Paediatr Child Health, 49(10), 820-4. doi: 10.1111/jpc.12292. Epub 2013 Jun 18. PMID: 23781950.
• Dogan, M., & Demirci, S. (2010). Vitamin B12 and its effects in neurological disorders. Suleyman Demirel University The Journal of Health Science, 1(1), 23-9.
• Graham, S.M., Arvela, O.M., & Wise, G.A. (1992). Long-term neurologic consequences of nutritional vitamin B12 deficiency in infants. J Pediatr, 121(5 Pt 1), 7, 10-4, doi: 10.1016/s0022-3476(05)81897-9. PMID: 1432418.
• Hafızoglu, M. (2020). Assessment of the Relationship Between Vitamin B12 Vitamin Deficiency and Severe Depression. Journal of Uludağ University Medical Faculty, 46(1), 71-76, https://doi.org/10.32708/uutfd.700927
• Healton, E.B., Savage, D.G., Brust, J.C., Garrett, T.J., & Lindenbaum, J. (1991). Neurologic aspects of cobalamin deficiency. Medicine (Baltimore), 70(4), 229-45. doi: 10.1097/00005792-199107000-00001. PMID: 1648656.
• Hector, M., & Burton, JR. (1988). What are the psychiatric manifestations of vitamin B12 deficiency? J Am Geriatr Soc, 36(12), 1105-12. doi: 10.1111/j.1532-5415.1988.tb04397.x. PMID: 3057051.
• Keskin, E.Y. (2016). Disappearance of cerebral cortical atrophy following replacement therapy with vitamin B12 in an infant.Cukurova Medical Journal, 41(1), 156-160.
• Kirik, S., & Çatak, Z. (2021). Vitamin B12 Deficiency Observed in Children With First Afebrile Seizures. Cureus, 13(3), 13745. DOI 10.7759/cureus.13745.
• Koc, A., Kocyigit, A., Soran, M., Demir, N., Sevinc, E., Erel, O., & Mil, Z. (2006). High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. Eur J Nutr, 45(5), 291-7. doi: 10.1007/s00394-006-0598-7. Epub 2006 Apr 6. PMID: 16601915.
• Kumar, S. (2004). Recurrent seizures: an unusual manifestation of vitamin B12 deficiency. Neurol India, 52, 122-3.
• Lee, G.R. (1993). Megaloblastic and nonmegaloblastic macrocytic anemias. In: G.R. Lee, T.C. Bithell, J. Foerster, J.W. Athens, J.N. Lukens (Ed.) Wintro be’s Clinical Hematology. Philadelphia, 745-807.
• Lee, M., Chang, H.S., Wu, H.T., Weng, H.H., & Chen, C.M. (2005). Intrac- table epilepsy as the presentation of vitamin B12 deficiency in the absence of macrocytic anaemia. Epilepsia, 46, 1147-8.
• McCaddon, A. (2013). Vitamin B12 in neurology and ageing; clinical and genetic aspects. Biochimie. 95(5), 1066-76. doi: 10.1016/j.biochi.2012.11.017. Epub 2012 Dec 7. PMID: 23228515.
• Nawaz, A., Khattak, N.N., Khan, M.S., & Nangyal, H. (2020). Deficiency of vitamin B 12 and its relation with neurological disorders: a critical review. The Journal of Basic and Applied Zoology, 81(1), 1-9.
• Taşkesen, M., Yaramış, A., Katar, S., Pi̇ri̇nççi̇oğlu, A., & Söker, M. (2011). Neurological presentations of nutritional vitamin B12 deficiency in 42 breastfed infants in Southeast Turkey. Turk J Med Sci, 41, 1091-1096.
• Zengin, E., Sarper, N., & Kilic, S.C. (2009). Clinical manifestations of infants with nutritional vitamin B12 deficiency due to maternal dietary deficiency. Acta Paediatrica, 98, 98-102.