Vitamin B Deficiencies in a Critically Ill Autistic Child With a Restricted Diet

Baird, John Scott; Ravindranath, Thyyar

doi:10.1177/0884533614541483

Cited by 19 publications

(21 citation statements)

References 17 publications

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“…Three other children presented to pediatric hematology for hematological complications and were subsequently diagnosed with scurvy secondary to diet limitations [14] and one child receiving homemade tube feedings presented with scurvy [10]. While the current study described a child presenting with a vitamin C deficiency and discussed the literature describing cases of scurvy in the pediatric population, nutrient deficiencies are not limited to vitamin C, other clinical presentations involving other vitamin deficiencies, including vitamin A [15], vitamin B 1 [16], and vitamin D [17] have all been reported in children with limited diets. Even though the presentation of children with nutrient deficiencies may not be commonplace for most providers, children at-risk for nutrient deficiencies will be seen far more often.…”

Section: Discussionmentioning

confidence: 99%

Is vitamin C enough? A case report of scurvy in a five-year-old girl and review of the literature

2019

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Background Numerous cases of scurvy secondary to diet limitations have been reported in the literature with most being boys with special needs. To date, the focus of the literature describing vitamin C deficiency has been the medical sequelae of the deficiency. There has been little attention given underlying diet limitations causing the vitamin C deficiency. Case presentation A five-year-old female with typical development initially presented with rash, then later for pain in both lower extremities. After evaluation revealed vitamin C deficiency, she was admitted into an intensive day treatment feeding program. A feeding assessment found she had life-long problems with eating and had a diet that never exceeded ten foods. Across the course of treatment, she learned to eat 29 new foods. At six-month follow-up her body mass index had increased from the 1st to the 61st percentile. At one-year follow-up her body mass index was at the 85th percentile. All sequalae of her deficiency resolved. Conclusions This case is unusual as most reported studies describe males with special needs. The severity of her eating issues suggest providers may consider referral to allied health professionals to address diet limitations for both children identified with nutrient deficiencies as well as children whose selective eating places them at risk for nutritional deficiencies or problems with growth. The child we described was anemic, like 42% of children described in the case literature on scurvy and like 32% of the children in this literature, our patient was underweight. In the literature, comorbid nutrient deficiencies were reported in 22% of the scurvy case studies. We suggest vitamin C supplementation is a necessary component for addressing vitamin C deficiency, but insufficient for addressing the diet limitations causing the nutrient deficiency. Electronic supplementary material The online version of this article (10.1186/s12887-019-1437-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Is vitamin C enough? A case report of scurvy in a five-year-old girl and review of the literature

2019

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“…Lactic acid decreased rapidly with administration of thiamin and status epilepticus was associated with low serum pyridoxine. This was also resolved by the administration of pyridoxine [18]. Brain damage in infantile autism may involve the same complex of brainstem nuclei that are damaged by alcohol abuse, thiamin deficiency, and asphyxia.…”

Section: The Potential Role Of Malnutrition In Autismmentioning

confidence: 99%

The Dilemma of Raised Blood Levels of Folate and B12 in Autism

Lonsdale¹

2018

J Neurodegener Disord

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It has recently been reported that a raised level of folate and/or vitamin B12 in the blood of a newly parturient woman forecasts a marked increase in the possibility that the newborn infant will later develop autisma. The text that follows refers to the cases of two boys, each of which had suffered repeated episodes of acute febrile cervical lymphadenopathy. The medical history of one of the boys revealed that he had been previously admitted to a hospital during an episode of febrile lymphadenopathy. An enlarged cervical node had been removed for biopsy and it had been reported that its architecture, apart from its enlargement, was normal. In addition, it had been found that blood levels of folate and vitamin B12 were markedly increased. His mother had been accused of giving him too many supplements of vitamins, including folate and vitamin B12. She stated that she had not been giving the boy any vitamin supplements at all, a fact that was met with disbelief. Both boys had been indulged with sweets and each were found to have laboratory evidence of thiamin deficiency or abnormal status. One of the boys was studied in detail and the elevation of folate and B12 in the blood was confirmed. He was treated with large doses of thiamin as an outpatient. On his return the blood folate and vitamin B12 were found to be in the normal range. Thiamin therapy was discontinued and three weeks later he had another episode of febrile lymphadenopathy which was preceded by nocturnal sleepwalking accompanied by spontaneous enuresis. Blood folate and B12 were again elevated and thiamin treatment was restarted. With overall improvement in health and no further episodes of febrile lymphadenopathy, the folate and B12 levels were again normal when he returned for follow-up.

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“…Кишечная недостаточность при энтеропатиях Кишечная недостаточность при энтеропатиях различ-ного генеза приводит к мальабсорбции как макро-, так и микроэлементов (Fe, Zn, Cu, Mg, Se, фосфора, фолиевой кислоты, Ca, витаминов A, Е, D, а также группы В) со слож-ными механизмами нарушения всасывания каждого из них [20,[26][27][28][29][30].…”

Section: фармакоэкономика в педиатрииunclassified

Half-elemental Nutrition Mixtures for Enteral Nutrition of Children in Critical Conditions: Features of Usage and Economic Efficiency

Берестенникова¹

2015

Pediatr. farmakol.

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Особенности применения и экономическая эффективность полуэлементных смесей для энтерального питания детей в критических состояниях ВВЕДЕНИЕПо данным целого ряда клинических исследова-ний и метаанализов, энтеральное питание (ЭП) через назогастральный или назоеюнальный зонд у больных и ослабленных пациентов показало свое превосходство над парентеральным питанием (ПП) [1][2][3][4]. Больным в критическом состоянии, нуждающимся в нутритивной поддержке, европейские, канадские и американские руководства рекомендуют преимущественно энтераль-ный путь введения нутриентов [5][6][7]. В настоящее время обсуждение переключилось от оптимального способа введения к выбору периода начала нутритивной под-держки: по мнению экспертов, своевременность назна-чения ЭП крайне важна.Задержка с обеспечением зондового кормления в течение 72 ч обусловливает атрофию слизистой обо-

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Vitamin B Deficiencies in a Critically Ill Autistic Child With a Restricted Diet

Cited by 19 publications

References 17 publications

Is vitamin C enough? A case report of scurvy in a five-year-old girl and review of the literature

Is vitamin C enough? A case report of scurvy in a five-year-old girl and review of the literature

The Dilemma of Raised Blood Levels of Folate and B12 in Autism

Half-elemental Nutrition Mixtures for Enteral Nutrition of Children in Critical Conditions: Features of Usage and Economic Efficiency

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