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Published on: January 19, 2024
[Vitamin B(12) deficiency anaemia in a 7.5 months old girl]
Malgorzata Jarosz1, Ninela Irga, Jolanta Wierzba
1Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii, Akademia Medyczna, Debinki 7, 80-211 Gdańsk, Poland. m.jarosz@amg.gda.pl
Insights
Vitamin B12 deficiency in infants can cause severe developmental issues. Early diagnosis and supplementation are crucial for recovery, especially in exclusively breastfed infants of mothers with unrecognized pernicious anemia.
Area of Science:
- Pediatrics
- Hematology
- Nutrition
Background:
- Infants typically have sufficient Vitamin B12 stores for the first year.
- Exclusive breastfeeding can lead to Vitamin B12 depletion if maternal intake is insufficient.
- Maternal conditions like pernicious anemia or long-term vegetarianism can impact infant Vitamin B12 levels.
Observation:
- A 7.5-month-old infant presented with symptoms suggestive of acute leukemia.
- The infant was exclusively breastfed, and investigations revealed severe Vitamin B12 deficiency anemia.
- The underlying cause was identified as undiagnosed pernicious anemia in the mother.
Findings:
- Vitamin B12 deficiency anemia was diagnosed in the infant.
- Pernicious anemia was diagnosed in the mother, identified during pregnancy but not treated.
- Prompt Vitamin B12 supplementation and dietary changes led to rapid improvement in the infant.
Implications:
- Highlights the critical need to screen breastfeeding mothers for Vitamin B12 deficiency.
- Undiagnosed maternal cobalamin deficiency can lead to severe, potentially fatal, infant neurological and hematological complications.
- Early intervention with Vitamin B12 is vital for reversing developmental delays and ensuring a positive prognosis.
Abstract:
Vitamin B(12) stores at birth are adequate for infants until the end of the first year of life even if it 's concentration in maternal breast milk is low. However, there are some situations in which infants have depleted vitamin B(12) stores and in addition have a low dietary intake of cobalamin. Vitamin B(12) depletion occurs in infants who are exclusively breastfed by mothers who have unrecognized pernicious anemia or are strict vegetarians for many years. In those infants symptoms of bone marrow disfunction and impaired development of the central nervous system appear already in the first months of life. Unrecognized cobalamin deficiency may lead to serious neurologic consequences, and even to the death of the child. The authors present a case of a 7.5 month old girl admitted to the Department of Paediatrics, Haematology, Oncology and Endocrinology. Gdańsk Medical University suspected of acute leukaemia. Based on a detailed diagnostic procedure a final diagnosis of vitamin B(12) deficiency anaemia was established. The child was exclusively breast-fed. Results of investigations into the reason for cobalamin deficiency in the patient s organism. Led to the diagnosis of pernicious anaemia in the mother. Such a suspicion had been made during pregnancy, but no continuation of investigations nor appropriate treatment were implemented. After treatment with vitamin B(12) supplements and modification of the diet the patient improved quickly and remarkably. A few months follow-up was enough to observe remarkable improvement of psychomotor development of this child.
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