Vitamin B12 deficiency presenting as oedema in infants of vegetarian mothers
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
We report two cases of nutritional vitamin B12 deficiency in infancy, highlighting the importance of B12 supplementation to vegetarian mothers during pregnancy and breast-feeding.
The first patient, a 9-month-old Caucasian girl, presented with a 3-week history of generalised puffiness. She was born at term to a vegetarian mother. The infant was exclusively breast-fed as she was not interested in solids. Her height and weight were above the 75th percentile and head circumference just below the 75th percentile. She could sit without support and was pale with an expressionless face.
Laboratory investigations demonstrated macrocytic anaemia (haemoglobin 8.3 g/dl, MCV 101.4 fl) and hypoalbuminaemia (23 mg/l). Serum vitamin B12 was low at 49 ng/l (reference range 150–900 ng/l). Ferritin and folate levels were normal. Maternal vitamin B12 level was 185 ng/l. Following intramuscular injections of vitamin B12, her oedema resolved and she became more responsive. Two months later, she had a normal ...
- Almadan MS, al Awamy BH, al Mulhim IA (1993) Nutritional vitamin B12 deficiency in infancy. Indian J Paediatr 60: 683–685
- Baker SJ, Jacob E, Rajan KT, Swaminathan SP (1988) Vitamin B12 deficiency in pregnancy and peurperium. BMJ 16: 1658–1661
- Graham SM, Arvela OM, Wise GA (1992) Long term neurological consequences of nutritional vitamin B12 deficiency in infants. J Pediatr 121: 710–714
- Higginbottom MC, Sweetman L, Nyhan WL (1978) Syndrome of methylmalonic aciduria, homocystinuria, megaloblastic anemia and neurological abnormalities in a vitamin B12 deficient breast-fed infant of a strict vegetarian. N Engl J Med 299: 317–323
- Korenke GC, Hunneman DH, Eber S, Hanefeld F (2004) Severe encephalopathy with epilepsy in an infant caused by subclinical maternal pernicious anaemia: case report and review of literature. Eur J Pediatr 163: 196–201 CrossRef
- Renault F, Verstichel P, Ploussard JP, Costil J (1999) Neuropathy in two cobalamin-deficient breast-fed infants of vegetarian mothers. Muscle Nerve 22: 252–254 CrossRef
- Vitamin B12 deficiency presenting as oedema in infants of vegetarian mothers
European Journal of Pediatrics
Volume 164, Issue 4 , pp 257-258
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors