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Coma and respiratory failure in a child with severe vitamin B(12) deficiency

Daniela Codazzi1, Francesca Sala, Rossella Parini

  • 1Terapia Intensiva Pediatrica, Ospedali Riuniti, Bergamo, Italy.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 29, 2005
PubMed

Insights

Severe vitamin B12 deficiency in an infant, caused by maternal veganism, led to neurological issues. While vitamin B12 treatment rapidly improved hematological and some neurological symptoms, complete recovery was not achieved, highlighting the importance of early diagnosis and intervention.

Area of Science:

  • Pediatric Neurology
  • Nutritional Deficiencies
  • Developmental Pediatrics

Background:

  • Vitamin B12 is crucial for neurological development in infants.
  • Maternal dietary practices, such as strict veganism, can lead to vitamin B12 deficiency in breastfed infants.
  • Untreated vitamin B12 deficiency can cause severe neurological impairment.

Observation:

  • A 10-month-old infant presented with respiratory failure, hypotonia, and involuntary movements.
  • Brain imaging revealed diffuse cortical-subcortical atrophy.
  • Severe anemia and macrocytosis suggested vitamin B12 deficiency, linked to the mother's long-term vegan diet.

Findings:

  • Vitamin B12 supplementation resulted in rapid hematological normalization and partial regression of neurological symptoms within two weeks.
  • Despite three years of treatment and rehabilitation, the infant exhibited persistent linguistic and psychomotor delays.
  • Brain atrophy showed regression, but neurological deficits remained.

Implications:

  • Early detection and prompt treatment of vitamin B12 deficiency are critical in infants.
  • While treatment can reverse some effects, neurological damage may be irreversible.
  • This case underscores the need for nutritional screening in infants of mothers with restrictive diets.
Abstract

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