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Psychomotor regression due to vitamin B12 deficiency.
Pan Afr Med J. 2018; 30:152.PA

Abstract

A vitamin B12 deficiency in infants is rare, but may sometimes be seen in breastfed babies of strict vegetarian mothers. Vitamin B12, also known as cobalamin, is only found in meat and other animal products. Most babies have a sufficient supply as long as the mother was not deficient herself. Symptoms and signs of vitamin B12 deficiency appear between the ages of 2 to 12 months and include vomiting, lethargy, failure to thrive, hypotonia, and arrest or regression of developmental skills. Urinary concentrations of methylmalonic acid and homocystine are characteristically elevated in vitamin B12 deficiency. Early treatment for a vitamin B12 deficiency in an infant involves immediate administration of vitamin B12 to the baby and the breastfeeding mother. The infant and mother will each receive an injection of vitamin B12 containing 1,000 mcg or more of the vitamin, and the mother will continue to receive injections every month to raise her own stores. After the initial injection, the baby will often receive future vitamin B12 through food sources. We present a case of vitamin B12 deficiency in a 9-month-old girl presented with psychomotor regression, hypotonia and lethargy. The child was exclusively breast-fed from birth by a mother who was on strict vegetarian diet and belong to a low socio-economic status. Laboratory data revealed bicytopenia with macrocytic anemia and methylmalonic acid in the urine, consistent with vitamin B12 deficient anemia. The Brain CT revealed a cerebral atrophy and delayed myelination. Vitamin B12 supply was effective on anaemia and psychomotor delay. This case figures out the importance of an early diagnosis in front of psychomoteur regression and hypotonia, given the risk of incomplete neurologic recovery due to vitamin B12 deficiency mainly in the setting of maternal nutritional deficiency.

Authors+Show Affiliations

Department of Paediatrics 2, Unit of Endocrinology and Neuropediatrics, Children's Hospital, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.Department of Paediatrics 2, Unit of Endocrinology and Neuropediatrics, Children's Hospital, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.Department of Paediatrics 2, Unit of Endocrinology and Neuropediatrics, Children's Hospital, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.Department of Paediatrics 2, Unit of Endocrinology and Neuropediatrics, Children's Hospital, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30374398

Citation

Bousselamti, Amal, et al. "Psychomotor Regression Due to Vitamin B12 Deficiency." The Pan African Medical Journal, vol. 30, 2018, p. 152.
Bousselamti A, El Hasbaoui B, Echahdi H, et al. Psychomotor regression due to vitamin B12 deficiency. Pan Afr Med J. 2018;30:152.
Bousselamti, A., El Hasbaoui, B., Echahdi, H., & Krouile, Y. (2018). Psychomotor regression due to vitamin B12 deficiency. The Pan African Medical Journal, 30, 152. https://doi.org/10.11604/pamj.2018.30.152.12046
Bousselamti A, et al. Psychomotor Regression Due to Vitamin B12 Deficiency. Pan Afr Med J. 2018;30:152. PubMed PMID: 30374398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychomotor regression due to vitamin B12 deficiency. AU - Bousselamti,Amal, AU - El Hasbaoui,Brahim, AU - Echahdi,Hanae, AU - Krouile,Yamna, Y1 - 2018/06/20/ PY - 2017/02/19/received PY - 2018/01/16/accepted PY - 2018/10/31/entrez PY - 2018/10/31/pubmed PY - 2018/11/21/medline KW - Vitamin B12 deficiency KW - breastfeeding KW - hyperhomocysteinemia KW - hypotonia KW - psychomotor regression SP - 152 EP - 152 JF - The Pan African medical journal JO - Pan Afr Med J VL - 30 N2 - A vitamin B12 deficiency in infants is rare, but may sometimes be seen in breastfed babies of strict vegetarian mothers. Vitamin B12, also known as cobalamin, is only found in meat and other animal products. Most babies have a sufficient supply as long as the mother was not deficient herself. Symptoms and signs of vitamin B12 deficiency appear between the ages of 2 to 12 months and include vomiting, lethargy, failure to thrive, hypotonia, and arrest or regression of developmental skills. Urinary concentrations of methylmalonic acid and homocystine are characteristically elevated in vitamin B12 deficiency. Early treatment for a vitamin B12 deficiency in an infant involves immediate administration of vitamin B12 to the baby and the breastfeeding mother. The infant and mother will each receive an injection of vitamin B12 containing 1,000 mcg or more of the vitamin, and the mother will continue to receive injections every month to raise her own stores. After the initial injection, the baby will often receive future vitamin B12 through food sources. We present a case of vitamin B12 deficiency in a 9-month-old girl presented with psychomotor regression, hypotonia and lethargy. The child was exclusively breast-fed from birth by a mother who was on strict vegetarian diet and belong to a low socio-economic status. Laboratory data revealed bicytopenia with macrocytic anemia and methylmalonic acid in the urine, consistent with vitamin B12 deficient anemia. The Brain CT revealed a cerebral atrophy and delayed myelination. Vitamin B12 supply was effective on anaemia and psychomotor delay. This case figures out the importance of an early diagnosis in front of psychomoteur regression and hypotonia, given the risk of incomplete neurologic recovery due to vitamin B12 deficiency mainly in the setting of maternal nutritional deficiency. SN - 1937-8688 UR - https://www.unboundmedicine.com/medline/citation/30374398/Psychomotor_regression_due_to_vitamin_B12_deficiency_ L2 - https://www.panafrican-med-journal.com/content/article/30/152/full/ DB - PRIME DP - Unbound Medicine ER -