Vomiting as a Presenting Symptom of Infantile Vitamin B12 Deficiency

Abstract

An 8-month-old, exclusively breastfed girl presented with a five-month history of vomiting with subsequent failure to thrive and lethargy. Family history was notable for the maternal history of gastroschisis. Mother had no dietary restrictions and had successfully breastfed multiple children for >12 months without issue. Initial evaluation was notable for macrocytic anemia. Subsequent serum B 12 levels were undetectable. Upon further questioning, the mother had significant bowel resection as an infant due to complications of gastroschisis. Maternal serum B 12 levels were also undetectable. The infant’s symptoms resolved with supplementation.

When do you think that the cause of the problem is vitamin B12 deficiency?

“…18,19 Osim neuroloških simptoma, deficit kobalamina kod dojenčadi može se prezentirati i ga strointestinalnim tegobama poput povraćanja, proljeva i otežanog uzimanja obroka. 20…”

Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published between 1962 and 2022

“…A total of 116 studies were included in step one of the analyses. Fourteen publications covering 16 cases had to be excluded due to missing, implausible, or non-numeric data (e.g., ranges or interpretations of values) [17][18][19][20][21][22][23][24][25][26][27][28][29].…”