Vitamin B12 deficiency presenting as oedema in infants of vegetarian mothers

Reghu, Anjana; Hosdurga, Saraswati; Sandhu, Bhupinder; Spray, Christine

doi:10.1007/s00431-004-1616-5

Cited by 14 publications

(7 citation statements)

References 6 publications

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“…From these case studies the following data were summarized: type of symptom; reported age when symptoms initially developed; age at which symptoms were diagnosed as being caused by vitamin B 12 deficiency (0–8 months after the first symptom appeared, with a median diagnostic delay of 4 months); serum B 12 concentration of the infant (reported in all but two cases, although in 10 cases the value was reported as “less than” 45 or 50 pg/mL); serum B 12 concentration of the mother (reported in all but 10 cases); breast milk B 12 concentration; anemia and megaloblastosis in infant blood; anthropometry; feeding practices, including refusal of complementary food; appetite; and any other data related to infant development (Table 1). 9,13–42 …”

Section: Pooled Analysis Of Case Studiesmentioning

confidence: 99%

Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms

2008

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Severe vitamin B(12) deficiency produces a cluster of neurological symptoms in infants, including irritability, failure to thrive, apathy, anorexia, and developmental regression, which respond remarkably rapidly to supplementation. The underlying mechanisms may involve delayed myelination or demyelination of nerves; alteration in the S-adenosylmethionine:S-adenosylhomocysteine ratio; imbalance of neurotrophic and neurotoxic cytokines; and/or accumulation of lactate in brain cells. This review summarizes the current knowledge concerning infantile vitamin B(12) deficiency, including a pooled analysis of case studies of infants born to mothers with untreated pernicious anemia or a strict vegetarian lifestyle and a discussion of the mechanisms that may underlie the manifestations of deficiency.

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Section: Pooled Analysis Of Case Studiesmentioning

confidence: 99%

Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms

2008

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“…Additional case reports have continued to appear, several emphasising the persistence of neurological deficits despite Cbl therapy [Emery et al , 1997; Goraya, 1998; Centers for Disease Control and Prevention (CDC), 2003; Korenke et al , 2004; Şimşek et al , 2004; Weiss et al , 2004; Codazzi et al , 2005; Reghu et al , 2005; Roschitz et al , 2005]. Cranial magnetic resonance imaging (MRI) studies have shown severe cerebral atrophy and retarded myelination (Lövblad et al , 1997) with persistence of neurological deficits even after complete resolution of all MRI abnormalities (von Schenck et al , 1997).…”

Section: Dietary Deficiency Of Cobalamin and Folatementioning

confidence: 99%

Acquired and inherited disorders of cobalamin and folate in children

Whitehead

2006

Br J Haematol

140

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SummaryCobalamin deficiency in the newborn usually results from cobalamin deficiency in the mother. Megaloblastic anaemia, pancytopenia and failure to thrive can be present, accompanied by neurological deficits if the diagnosis is delayed. Most cases of spina bifida and other neural tube defects result from maternal folate and/or cobalamin insufficiency in the periconceptual period. Polymorphisms in a number of genes involved in folate and cobalamin metabolism exacerbate the risk. Inborn errors of cobalamin metabolism affect its absorption, (intrinsic factor deficiency, Imerslund-Gräsbeck syndrome) and transport (transcobalamin deficiency) as well as its intracellular metabolism affecting adenosylcobalamin synthesis (cblA and cblB), methionine synthase function (cblE and cblG) or both (cblC, cblD and cblF). Inborn errors of folate metabolism include congenital folate malabsorption, severe methylenetetrahydrofolate reductase deficiency and formiminotransferase deficiency. The identification of disease-causing mutations in specific genes has improved our ability to diagnose many of these conditions, both before and after birth.

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“…Numerous studies showed that breastfeeding infants of mothers with vegan diets can develop severe vitamin B12 deficiency and irreversible neurological damage [13, 18, 34, 45]. Thus, mothers with vegan or vegetarian diets need to take vitamin B12 supplements, preferably combined with other critical nutrients such as iron, zinc, iodine, vitamin D and DHA [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Vegetarian diets in childhood and adolescence

et al. 2019

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In Western countries, vegetarian diets are associated with lower intakes of energy, saturated fatty acids and animal protein and higher intakes of fibre and phytochemicals, compared to omnivorous diets. Whether the corresponding health benefits in vegetarians outweigh the risks of nutrient deficiencies has not been fully clarified. It should be noted that vegetarians often have a higher socioeconomic status, follow a more health-conscious lifestyle with higher physical activity, and refrain from smoking more often than non-vegetarians. The nutritional needs of growing children and adolescents can generally be met through a balanced, vegetable-based diet; however, due to their higher nutrient requirements per kilogramme of body weight, vegetarian children have a higher risk for developing nutrient deficiencies than adults. With a vegetarian diet, the mean intakes of some nutrients, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are lower than in omnivores or those eating fish. For other nutrients, such as iron and zinc, the bioavailability from vegetable foodstuffs is reduced when the intake of phytates and fibre is high; thus, the prevalence of iron deficiency can be increased despite high vitamin C intake. In addition, vitamin B12 is only found in animal-source foods. Vitamin B12 should be supplemented in people of all age groups who follow a strict vegan diet without consuming animal products. A vegetarian diet in childhood and adolescence requires good information and supervision by a paediatrician, if necessary, in cooperation with an appropriately trained dietary specialist.

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Vitamin B12 deficiency presenting as oedema in infants of vegetarian mothers

Cited by 14 publications

References 6 publications

Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms

Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms

Acquired and inherited disorders of cobalamin and folate in children

Vegetarian diets in childhood and adolescence

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