Psychomotor regression due to vitamin B12 deficiency

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.

Interactions between gut microbiota and skeletal muscle

“…Solid arrow lines illustrate well-documented links, whereas dotted arrow lines show links that remain to be confirmed by further studies. Animal derived food (eg, raw liver of beef, pork, or chicken, fish, and shellfish); plant derived food 37 Deficiency related to muscle and neurological dysfunctions, ↓ energy and exercise tolerance 35,38,39 Vitamin K2 (menaquinones)…”

Malnutrition, Health and the Role of Machine Learning in Clinical Setting

“…Studies on protein malnutrition have demonstrated increased hippocampal expression of trkB & GAP-43 protein, indicating increased stress response (11). In addition to macronutrients, deficiencies in micronutrients, including vitamins, are implicated in a variety of disorders and delayed recovery mechanisms (12). Vitamin B12 which is essential in the conversion of homocysteine to methionine via methionine synthase for DNA and RNA synthesis (13), produces a large number of biological agents, including the myelin sheath.…”

Importância da vitamina B12 para a função neurológica e cognitiva: da gestação à infância

“…A relação da vitamina B12 materna com o da sua prole destaca o papel crucial de gestação para prevenir a deficiência de B12 na próxima geração. É importante ressaltar que há diretrizes para a fortificação de farinha com B12 desenvolvidas pela Food Fortification Initiative 36,37 e aprovadas pela Organização Mundial de Saúde (OMS). Além disso, como a farinha na maioria dos países agora é fortificada com ácido fólico, a cofortificação com B12 eliminaria qualquer uma das preocupações, ainda controversas, sobre o alto nível de folato exacerbar a deficiência de B12 38,39 .…”