Acquired Vitamin B12 Deficiency in Infancy

Abstract

Vitamin B12 deficiency can be acquired in infants secondary to exclusive breastfeeding in deficient mothers. In this series of seven infants with acquired vitamin B12 deficiency, clinical features included developmental impairment/regression, faltering growth, feeding difficulties, somnolence, irritability, microcephaly, seizures, and abnormalities on brain magnetic resonance imaging. All had methylmalonic aciduria, other investigation findings were low serum cobalamin and hyperhomocysteinemia. Treatment brought about improvement in growth, behavior, and development; however, development remained impaired in some. We recommend early detection by screening in infants with suggestive clinical presentations, using urine methylmalonic acid/plasma homocysteine as screening tools, maternal screening during pregnancy, and long-term neurodevelopmental follow-up.

Review of Vitamin B12 deficiency in pregnancy: a diagnosis not to miss as veganism and vegetarianism become more prevalent

“…Several authors have recommended newborn screening to identify moderate and severe cases of vitamin B12 deficiency because it is feasible and effective 28–32 . Others have argued that there is not a sufficiently reliable test to implement screening widely 33 …”

Infantile Acquired Vitamin B12 Deficiency

“…We read the article on "Acquired Vitamin B12 Deficiency in Infancy" with a great interest. 1 Fadilah et al concluded that "We recommend early detection by screening in infants with suggestive clinical presentations, using urine methylmalonic acid/plasma homocysteine as screening tools, maternal screening during pregnancy, and long-term neurodevelopmental follow-up." 1 We would like to share ideas on this topic.…”