Megaloblastic Anaemia of Infancy and Vitamin B₁₂

Abstract

SUMMARY The haematological status of 30 infants with a syndrome characterized by satisfactory growth, abnormal pigmentation, developmental retardation, hypotonia of muscles, hepatosplenomegaly, with or without tremors, has been studied. Anaemia of a moderate degree was seen in all. All but four had megaloblastic erythropoiesis. Serum vitamin B12 levels were below 100 pg./ml. By increasing the infants' intake of vitamin B12>, by raising the concentration of the vitamin in maternal milk, megaloblastic erythropoiesis could be corrected to normoblastic erythropoiesis. The other clinical manifestations of the syndrome also responded to the administration of vitamin B12 to varying degrees.

Assessment of iron, folate and vitamin B12 status in children with infantile tremor syndrome

“…3,4,9,10,[12][13][14][18][19][20] Most of the workers have found vitamin B 12 deficiency in children with ITS but to the best of our knowledge and thorough web search ours is the first planned study to assess iron (serum ferritin) and folate status along with vitamin B 12 in children with ITS. 3,4,21 In our study all the ITS patients were anemic but none of them had low levels of folate or ferritin which are commonly responsible for anemia in children. This could be due to routine iron folic acid supplementation to pregnant and lactating mother and presence of subclinical infection which can increase serum ferritin as an acute phase reactant.…”

“…3,23 Concentration of vitamin B 12 in breast milk reflect maternal vitamin B 12 stores, and maternal vitamin B 12 stores are depleted in up to onethird of rural Indian women. 24,25 A study in rural Karnataka by SR Pasricha, et al also found that concentrations of ferritin and vitamin B 12 were decreased in toddlers who continued to receive breast milk.…”

“…1 Various theories has been postulated about etiopathogenesis of ITS including nutritional deficiency, infections, toxins and enzyme defects but none has been substantiated so far. [1][2][3][4] Although the mechanisms underlying the effect of maternal folate status on neural tube development are not well understood, the shared metabolism between folate and vitamin B 12 suggests that deficiencies in one vitamin may alter the metabolism of the other. This is perhaps related to the roles that vitamin B 12 plays in myelination, or in the synthesis of methionine from homocysteine in combination with folic acid.…”

Die Bedeutung von Vitamin B12 in der Schwangerschaft und daraus resultierende Empfehlungen für die Schwangerschaftsvorsorge

“…Es sind verschiedene Situationen bekannt, in denen bereits Säug-linge einen Vitamin-B 12 -Mangel entwickeln. Berichte aus Indien zeigen, dass Säuglinge von Müttern, die über einen längeren Zeitraum eine vegane Ernährung praktiziert haben oder einen sehr niedrigen Verzehr an Lebensmitteln tierischen Ursprungs aufweisen, innerhalb der ersten 4 ± 8 Lebensmonate Mangelsymptome wie Anämie, vermindertes Wachstum und neurologische Schäden entwickeln können [34,59]. Auch ein Tremor sowie exzessive Hautpigmentation wurden beschrieben [23].…”

“…Ab einer bestimmten Stufe können die Einschrän-kungen der mentalen Funktionen dauerhaft sein [35]. In den meisten Fällen können die Symptome jedoch durch eine parenterale Zufuhr von Vitamin B 12 bei der stillenden Mutter oder eine intramuskuläre Injektion beim Säugling wieder vollständig beseitigt werden [59].…”