Cranial magnetic resonance imaging findings of nutritional Vitamin B12 deficiency in 15 hypotonic infants

Taşkesen, Mustafa; Yaramış, Ahmet; Pirinççioğlu, Ayfer Gözü; Ekıcı, Faysal

doi:10.1016/j.ejpn.2011.08.005

Cited by 24 publications

(30 citation statements)

References 13 publications

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“…Although B12 deficiency is known to have neurological effects, there are few cases of neuroimaging in infants in the literature . Herein, we report cranial MRI findings of 21 infants with severe nutritional B12 deficiency.…”

Section: Discussionmentioning

confidence: 93%

Cerebral atrophy in 21 hypotonic infants with severe vitamin B12 deficiency

Acıpayam

Güneş

Güngör

et al. 2019

J Paediatrics Child Health

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Aim: Nutritional B12 deficiency is a treatable cause of neurodevelopmental delay in infants. We report 21 infants with developmental regression and brain atrophy as revealed using cranial magnetic resonance imaging (MRI), secondary to severe vitamin B12 deficiency.Methods: Twenty-one infants aged 4-24 months with B12 deficiencies who were admitted to our clinic between May 2013 and May 2018 were included in the study. MRI, bone marrow aspiration and the Denver-II Developmental Screening Test were performed in all infants. Results: The mean age of the infants was 12.3 months, and the mean B12 level was 70.15 AE 32.15 ng/L. Hypotonia and neurodevelopmental retardation, and anaemia were present in all patients. Their bone marrow examinations were compatible with megaloblastic anaemia. Twelve patients had microcephaly, seven had tremor and one patient died of severe sepsis. Almost all patients were fed with breast milk and their mothers were also malnourished. Nine (42.9%) of the patients were Turkish and 12 (57.1%) were Syrian. All patients had abnormal Denver-II Developmental Screening Test scores. Most patients had severe cortical atrophy, cerebral effusion, thinning of the corpus callosum and delayed myelinisation in cranial MRI. Treatment with B12 resulted in dramatic improvement in general activity and appetite within 72 h. Tremors resolved in all cases. Conclusion: Neurological findings and developmental delay related to nutritional B12 deficiency can be prevented without sequelae if diagnosed early. Screening and treating of mothers for this deficiency will contribute to the health of both the mother and their feeding infant.

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Section: Discussionmentioning

confidence: 93%

Cerebral atrophy in 21 hypotonic infants with severe vitamin B12 deficiency

Acıpayam

Güneş

Güngör

et al. 2019

J Paediatrics Child Health

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“…12,13 On the basis of a number of case reports, brain atrophy is also a pathologic feature in infants with vitamin B 12 deficiency. [14][15][16] Advanced MR imaging-based modalities such as DTI and MR spectroscopy showed abnormalities in a variety of diffuse neurologic disorders, whereas conventional MR imaging findings appeared normal. We hypothesized that patients with clinical symptoms of SACD and biochemical evidence of vitamin B 12 deficiency will have an associated cognitive decline and microstructural alterations in brain WM on DTI, even when conventional MR imaging findings appear normal.…”

mentioning

confidence: 99%

DTI Correlates of Cognition in Conventional MRI of Normal-Appearing Brain in Patients with Clinical Features of Subacute Combined Degeneration and Biochemically Proven Vitamin B12 Deficiency

Gupta

Garg

et al. 2013

American Journal of Neuroradiology

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“…Atrophy of corpus callosum, retardation in myelination, demyelination areas and ventricular dilatation findings were seen on the MR images. Cortical atrophy, hypoplasia of the corpus callosum, delayed myelination, and ventricular dilatation are the most common neuroradiological findings in the literature (3,30,31,34). Patients only presented with macrocephaly, irritability and tremor and we did not observe any seizure in the group where B 12 levels of mothers were normal.…”

Section: Discussionmentioning

confidence: 79%

“…However, vitamin B 12 deficiency is thought to cause imbalance between the growth factors influencing the central nervous system and neurotoxic cytokines, and increased lactate, glutamate and excitatory amino acids (26)(27)(28). There- (29)(30)(31)(32)(33)(34). We encountered central nervous system signs and symptoms especially in rapidly growing infants in the early period between 2 and 18 months.…”

Section: Discussionmentioning

confidence: 95%

How Does B12 Deficiency of Mothers Affect Their Infants?

et al. 2017

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Background: Vitamin B12 cannot be synthesized in the body and it is essential for growth and development in humans. Objectives: To evaluate the vitamin B12 levels between the mothers and their infants who presented to the Pediatric Hematology outpatients department due to the symptoms of vitamin B12 deficiency. We also compared the effects of low B12 levels in both the mother and the child, compared to the effects of normal B12 levels in the mother and low levels in the child. Methods: We enrolled 303 children aged 2 -18 months between January 2013 and September 2015. Patients with a vitamin B12 level < 200 pg/mL in both the mother and the child and patients with a B12 level that was low in the child and normal in the mother were compared. Results: The birth weight of the children was low in the group where the B12 level of both the mother and the child (n = 163) was low and presentation to the clinic with neurologic signs and symptoms such as tremor, restlessness, seizure, hypotonia, and macrocephaly not related to another etiologic reason was common (P < 0.05). A remarkable finding was the simultaneous low levels of vitamin B12 in the mother in 55 of the 69 children who presented with neurological symptoms (P < 0.05). A generalized or focal epileptic pathology was found in the EEGs and MR images including retardation in myelination, demyelination, atrophic findings or ventricular dilatation in children whose mothers have B12 deficiency simultaneously. Conclusions: It is difficult to explain such complicated clinical pictures due to malnutrition especially in developing countries. Detecting and treating vitamin B12 deficiency early in mother and child is very important in prevention of potential irreversible neurological problems.

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Cranial magnetic resonance imaging findings of nutritional Vitamin B12 deficiency in 15 hypotonic infants

Cited by 24 publications

References 13 publications

Cerebral atrophy in 21 hypotonic infants with severe vitamin B12 deficiency

Cerebral atrophy in 21 hypotonic infants with severe vitamin B12 deficiency

DTI Correlates of Cognition in Conventional MRI of Normal-Appearing Brain in Patients with Clinical Features of Subacute Combined Degeneration and Biochemically Proven Vitamin B12 Deficiency

How Does B12 Deficiency of Mothers Affect Their Infants?

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