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[Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers].
Cas Lek Cesk. 2001 Nov 22; 140(23):732-5.CL

Abstract

BACKGROUND

Serious hematological, metabolic and neurological complications owing to the nutritional deficiency of vitamin B12 may occur in infants of mothers on a strict vegetarian diet.

METHODS AND RESULTS

The mother of the first child was a strict vegetarian. She had an elevated urinary methylmalonic acid level and a low concentration of serum vitamin B12. Her 13-month-old daughter was exclusively breast-fed until the age of 9 month and then she was fed only vegetables. Physical examination revealed psychomotoric retardation, apathy, muscular hypotonia, abnormal movements and failure to thrive. Laboratory analysis showed a megaloblastic anaemia, a low level of vitamin B12 and methylmalonic aciduria. MRI of the brain revealed diffuse frontotemporoparietal atrophy and retardation of myelination. After treatment with vitamin B12 supplements, abnormal movements disappeared and development improved, but a mild generalised hypotonia continued. A cranial MRI 9 months after treatment still showed signs of retardation of myelination. The second patient, an 8 month-old male, son of a strict vegetarian mother too, was referred for investigation of psychomotoric retardation, hypotonia, dyskinesia, failure to thrive and microcephaly. He was breast-fed and from 6 month of age he had also received fruit juices. Laboratory analysis revealed megaloblastic anaemia, high methylmalonic aciduria and homocystinuria. The patient's and his mother's serum level of vitamin B12 were low. After treatment with vitamin B12 supplements, biochemical and metabolic markers of disease were normal but there continued a generalised hypotonia, microcephaly and language delay.

CONCLUSION

Our observations emphasize the health complications of nutritional cobalamine deficiency and a requirement of clinical, biochemical and metabolic monitoring in infants within strict vegetarian families.

Authors+Show Affiliations

Dĕtská klinika LF UP a FN, Olomouc. smolkav@fnol.czNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

cze

PubMed ID

11787236

Citation

Smolka, V, et al. "[Metabolic Complications and Neurologic Manifestations of Vitamin B12 Deficiency in Children of Vegetarian Mothers]." Casopis Lekaru Ceskych, vol. 140, no. 23, 2001, pp. 732-5.
Smolka V, Bekárek V, Hlídková E, et al. [Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers]. Cas Lek Cesk. 2001;140(23):732-5.
Smolka, V., Bekárek, V., Hlídková, E., Bucil, J., Mayerová, D., Skopková, Z., Adam, T., Hrubá, E., Kozich, V., Buriánková, L., Saligová, J., Buncová, M., & Zeman, J. (2001). [Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers]. Casopis Lekaru Ceskych, 140(23), 732-5.
Smolka V, et al. [Metabolic Complications and Neurologic Manifestations of Vitamin B12 Deficiency in Children of Vegetarian Mothers]. Cas Lek Cesk. 2001 Nov 22;140(23):732-5. PubMed PMID: 11787236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers]. AU - Smolka,V, AU - Bekárek,V, AU - Hlídková,E, AU - Bucil,J, AU - Mayerová,D, AU - Skopková,Z, AU - Adam,T, AU - Hrubá,E, AU - Kozich,V, AU - Buriánková,L, AU - Saligová,J, AU - Buncová,M, AU - Zeman,J, PY - 2002/1/15/pubmed PY - 2002/1/25/medline PY - 2002/1/15/entrez SP - 732 EP - 5 JF - Casopis lekaru ceskych JO - Cas. Lek. Cesk. VL - 140 IS - 23 N2 - BACKGROUND: Serious hematological, metabolic and neurological complications owing to the nutritional deficiency of vitamin B12 may occur in infants of mothers on a strict vegetarian diet. METHODS AND RESULTS: The mother of the first child was a strict vegetarian. She had an elevated urinary methylmalonic acid level and a low concentration of serum vitamin B12. Her 13-month-old daughter was exclusively breast-fed until the age of 9 month and then she was fed only vegetables. Physical examination revealed psychomotoric retardation, apathy, muscular hypotonia, abnormal movements and failure to thrive. Laboratory analysis showed a megaloblastic anaemia, a low level of vitamin B12 and methylmalonic aciduria. MRI of the brain revealed diffuse frontotemporoparietal atrophy and retardation of myelination. After treatment with vitamin B12 supplements, abnormal movements disappeared and development improved, but a mild generalised hypotonia continued. A cranial MRI 9 months after treatment still showed signs of retardation of myelination. The second patient, an 8 month-old male, son of a strict vegetarian mother too, was referred for investigation of psychomotoric retardation, hypotonia, dyskinesia, failure to thrive and microcephaly. He was breast-fed and from 6 month of age he had also received fruit juices. Laboratory analysis revealed megaloblastic anaemia, high methylmalonic aciduria and homocystinuria. The patient's and his mother's serum level of vitamin B12 were low. After treatment with vitamin B12 supplements, biochemical and metabolic markers of disease were normal but there continued a generalised hypotonia, microcephaly and language delay. CONCLUSION: Our observations emphasize the health complications of nutritional cobalamine deficiency and a requirement of clinical, biochemical and metabolic monitoring in infants within strict vegetarian families. SN - 0008-7335 UR - https://www.unboundmedicine.com/medline/citation/11787236/[Metabolic_complications_and_neurologic_manifestations_of_vitamin_B12_deficiency_in_children_of_vegetarian_mothers]_ L2 - https://medlineplus.gov/developmentaldisabilities.html DB - PRIME DP - Unbound Medicine ER -