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Vitamin B12 deficiency: the great masquerader
Sarah Dobrozsi1, Veronica H Flood, Julie Panepinto
1Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
Pediatric Blood & Cancer
|October 12, 2013
Summary
Vitamin B12 deficiency in children, though rare, presents with varied symptoms. Prompt B12 therapy is crucial to prevent irreversible neurological damage, even before blood count changes appear.
Area of Science:
- Pediatric Neurology
- Hematology
- Nutritional Deficiencies
Background:
- Vitamin B12 deficiency is uncommon in pediatric populations.
- Symptoms are often nonspecific, including failure to thrive, vomiting, anorexia, and neurological changes.
- Neuropathy associated with B12 deficiency can lead to severe, irreversible damage.
Observation:
- This study details four pediatric cases of Vitamin B12 deficiency.
- The deficiency was secondary to adult-type pernicious anemia, a protein abnormality, and a metabolic defect.
- All patients exhibited neurological compromise prior to or alongside other symptoms.
Findings:
- Neurological symptoms in these children significantly improved following Vitamin B12 administration.
- Hematological disturbances were not always present initially, highlighting the importance of considering B12 deficiency based on other symptoms.
- Early diagnosis and intervention are key.
Implications:
- Constitutional, gastrointestinal, or neurological changes in children warrant consideration for Vitamin B12 deficiency.
- Prompt therapeutic intervention with Vitamin B12 is essential to avert permanent neurological sequelae.
- This underscores the need for heightened clinical suspicion in diagnosing pediatric B12 deficiency.
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