Rodrigues Vera, Dias Alexandra, Brito Maria João, Galvão Isabel, Ferreira Gonçalo Cordeiro
Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
BMJ Case Rep. 2011 May 16;2011:bcr0220113835. doi: 10.1136/bcr.02.2011.3835.
Vitamin B(12) or cobalamin deficiency, a rare clinical entity in pediatric age, is found most exclusively in breastfed infants, whose mothers are strictly vegetarian non-supplemented or with pernicious anaemia. In this article, the authors describe a 10-month-old infant admitted for vomiting, refusal to eat and prostration. The infant was exclusively breastfed and difficulties in introduction of new foods were reported. Failure to thrive since 5 months of age was also noticed. Laboratory evaluation revealed severe normocytic normochromic anaemia and cobalamin deficit. A diagnosis of α-thalassemia trait was also made. Maternal investigation showed autoimmune pernicious anaemia. This case shows the severity of vitamin B(12) deficiency and the importance of adopting adequate and precocious measures in order to prevent potentially irreversible neurologic damage.
维生素B12或钴胺素缺乏在儿童期是一种罕见的临床病症，绝大多数见于纯母乳喂养的婴儿，其母亲为严格素食且未进行营养补充或患有恶性贫血。在本文中，作者描述了一名10个月大的婴儿，因呕吐、拒食和精神萎靡入院。该婴儿为纯母乳喂养，据报告在引入新食物方面存在困难。自5个月大以来还发现生长发育迟缓。实验室检查显示严重的正细胞正色素性贫血和钴胺素缺乏。同时还诊断出α地中海贫血特征。对母亲的检查显示患有自身免疫性恶性贫血。该病例显示了维生素B12缺乏的严重性以及采取适当和早期措施以预防潜在不可逆神经损伤的重要性。
