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Megaloblastäre und kongenitale dyserythropoetische Anämien

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Pädiatrische Hämatologie und Onkologie

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Zusammenfassung

Ein 6 Monate alter blasser Säugling wird im sozialpädiatrischen Zentrum wegen Entwicklungsrückschritten vorgestellt. Bei der U4 war ein altersgerechter Entwicklungsstatus dokumentiert worden. Jetzt hat das Kind beim Traktionsversuch keine Kopfkontrolle mehr, freies Sitzen hat es verlernt. Es fällt ferner auf, dass das voll gestillte Kind in den letzten 3 Wochen kein Gewicht zugenommen hat. Da die Mutter eine Blutentnahme zunächst ablehnt, wird unter der Verdachtsdiagnose Vitamin-B12-Mangel Spontanurin untersucht, der eine erhöhte Ausscheidung von Methylmalonsäure zeigt. In der wenig später doch gewonnen Blutprobe ist der Serum-Vitamin-B12-Spiegel deutlich erniedrigt. Im Blutbild finden sich Hämoglobin 5,7 g/dl, MCV 127 fl, Retikulozyten 50 Promille, Thrombozyten 100.000/μl und Leukozyten 3800/μl. Die erweiterte Anamnese erbringt, dass sich die Mutter als Veganerin seit mehreren Jahren und auch während der Schwangerschaft und Stillperiode ohne tierisches Eiweiß ernährt. Bei normalen Blutbildwerten hat sie eine deutlich erniedrigte Vitamin-B12 Serumkonzentration.

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Authors and Affiliations

  1. Klinik IV: Pä diatrische Hämatologie und Onkologie, Universitätsklinikum Freiburg Zentrum für Kinderheilkunde und Jugendmedizin, Mathildenstr. 1, 79106, Freiburg

    Prof. Dr. Charlotte Niemeyer & Priv.-Doz. Dr. Jochen Rössler

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  1. Prof. Dr. Charlotte Niemeyer
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  2. Priv.-Doz. Dr. Jochen Rössler
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Editors and Affiliations

  1. Forschungsinstitut für krebskranke Kinder, St. Anna Kinderspital, Kinderspitalgasse 6, 1090, Wien, Österreich

    Helmut Gadner

  2. Klinik für Allgemeine Pädiatrie und Knochenmarktransplantation, Charité Campus Virchow-Klinikum Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Augustenburger Platz 1, 13353, Berlin

    Gerhard Gaedicke

  3. Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg, Mathildenstr. 1, 79106, Freiburg

    Charlotte Niemeyer

  4. Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, 48129, Münster

    Jörg Ritter

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Niemeyer, C., Rössler, J. (2006). Megaloblastäre und kongenitale dyserythropoetische Anämien. In: Gadner, H., Gaedicke, G., Niemeyer, C., Ritter, J. (eds) Pädiatrische Hämatologie und Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29036-2_8

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  • DOI: https://doi.org/10.1007/3-540-29036-2_8

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