Crawford John Ross, Say Daphne
Department of Neurosciences and Pediatrics, University of California San Diego, San Diego, California, USA.
BMJ Case Rep. 2013 Mar 26;2013:bcr2013008840. doi: 10.1136/bcr-2013-008840.
A previously healthy 7-year-old Caucasian boy was hospitalised for evaluation of acute ataxia and failure to thrive, initially suspicious for an intracranial mass. Weight and body mass index were below the third percentile and he demonstrated loss of joint position and vibratory sense on examination. Laboratory studies revealed megaloblastic anaemia while an initial MRI of the brain showed no evidence of mass lesions or other abnormalities. A dietary history revealed the child subscribed to a restrictive vegan diet with little to no intake of animal products or other fortified foods. The child was diagnosed with presumed vitamin B12 deficiency and was treated with intramuscular B12 injections. Neurological symptoms resolved promptly within several days after starting therapy. This case underlines the importance of assessing nutritional status in the evaluation of neurological dysfunction in the pediatric patient.
一名此前健康的7岁白人男孩因急性共济失调和发育不良入院评估，最初怀疑有颅内肿块。体重和体重指数低于第三百分位，检查时发现他存在关节位置觉和振动觉丧失。实验室检查显示为巨幼细胞贫血，而最初的脑部MRI未发现肿块病变或其他异常迹象。饮食史显示，该儿童坚持严格的纯素饮食，几乎不摄入动物产品或其他强化食品。该儿童被诊断为疑似维生素B12缺乏，并接受了维生素B12肌肉注射治疗。开始治疗后数天内，神经症状迅速缓解。该病例强调了在评估儿科患者神经功能障碍时评估营养状况的重要性。
