Vitamin B12 deficiency with presenting nutritional difficulty: a case report.

Abstract

Vitamin B12 deficiency is among important causes of megaloblastic anemia. In developing countries, the major reason of Vitamin B12 deficiency is deficient dietary intake. Although vitamin B12 deficiency is a rare condition, early diagnosis and treatment are important to prevent permanent neurological sequela. Anorexia is seen frequently in children. We want to remind Vitamin B12 deficiency with this case presented with anorexia. A 12 month-old male patient presented with vomiting, weight loss, paleness, malnutrition, repulsion as well as growth retardation. Physical examination revealed paleness and loss of interest to environment. Hematologic test results were as follows: WBC: 6500 gr/dl, Hgb: 8.8 gr/dl, MCV: 96 fl, platelet count: 162.000/ mm3. Mean serum folic acid level of the patient was 19.4 ng/mL (3-22.4 ng/mL), and vitamin B12 level 72 pg/mL (200-1210 pg/mL), while mean vitamin B12 level of the mother was 96 pg/mL. The patient was diagnosed as vitamin B12 deficiency and intramuscular Vitamin B12 treatment was initiated. One month later, his vomiting ceased, his appetite was well and he gained 850 gr. His interest to environment was improved. We want to impress with this case that infants with anorexia might have vitamin B12 deficiency. Treatment of vitamin B12 deficiency is important because it might lead to permanent neurological sequela and vitamin B12 deficiency respond to treatment dramatically.