Does Vitamin B12 Deficiency in Infants Cause Severe Clinical Symptoms Necessitating Intensive Care?

Abstract

Introduction: Cobalamin (Cbl) deficient infants are mostly outpatients. Medical literature is very limited concerning infants with severe Cbl deficiency requiring intensive care. The aim of this study was to describe infants requiring intensive care whose health issues were primarily related to Cbl deficiency. Methods: This is a single-center retrospective observational study performed at the pediatric intensive care unit at a children's hospital. Patients aged 6-24 months with low serum Cbl level coexisting with cytopenia (s) and/or macrocytosis, high levels of iron, ferritin and transferin saturation and whose clinical symptoms necessitating intensive care at diagnosis and resolving after Cbl therapy were included. Infants with chronic diseases and birth asphyxia history were excluded. Results: Seven infants were included in the study. The mean age and Cbl level at presentation was 11±5 months and 50±27 pg/mL, respectively. The presenting complaints were diarrhea, vomiting, difficulty swallowing, seizure, respiratory distress and cyanosis after feeding. Three patients needed mechanical ventilation. Megaloblastic changes were detected in five patients who underwent bone marrow aspiration. Cerebral atrophy was found in six of the patients on cranial imaging. Only one patient developed neurological disability during long-term follow-up. Conclusion: This retrospective study was performed to emphasize the importance of Cbl deficiency in infants requiring intensive care or who had serious deterioration of organ functions. Cbl deficiency in children may lead to life-threatening complications such as respiratory failure or neurological disorders. Prompt diagnosis and immediate treatment may not only be life saving but also improves quality of life in long-term follow-up.

Clinical follow-up of children with high vitamin B12 values: should we worry?

“…We know better the relationship of Cbl deficiency and diseases. [1][2][3]8 Ideas are being developed about how vitamin B12 deficiency changes the clinics of other diseases. Autoanalysers offer fast, inexpensive, and results available on the same day and then we can use these results to decide patient treatment.…”

Evaluation of Clinical and Laboratory Findings of Children with Vitamin B12 Deficiency

“…Vitamin B12 deficiency is more common in developing countries. The prevalence varies between 3-40% in children in the world [8,9].…”

“…The admission complaints of individuals with Vitamin B12 deficiency vary among age groups. Patients may be asymptomatic or may be diagnosed with significant life-threatening hematological and neurological diseases [4][5][6]9]. Copy@ Erhan Aygün neurological symptoms, respectively.…”

Just a vitamin? Should cobalamin (Vitamin B12) levels be checked in children with neurological disadvantages?

“…Although Cbl deficiency is frequently discussed in the literature, the number of publications is very limited concerning children with high Cbl levels. However, some studies have recently reported that elevated serum levels of Cbl might be a sign of serious and life-threatening diseases, such as myeloproliferative disease, acute hepatitis, severe alcoholic liver disease, and cirrhosis [ 4 , 7 – 9 ].…”