Kanti Children's Hospital, Maharajganj, Kathmandu,Nepal.
Department of Pediatrics, Kanti Children's Hospital, Maharajganj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2021 Nov 15;59(243):1182-1184. doi: 10.31729/jnma.6600.
Vitamin B12 deficiency in children can cause megaloblastic anemia, poor growth, and increased chances of infections. It is an important reversible cause of bone marrow suppression which at the time of presentation can mimic hematological malignancy. Therefore, it should be considered as a differential diagnosis in cases suspected of acute leukemia. We report a case of 14 months old child who had atypical presentation of vitamin B12 deficiency. He had chronic fever, decreased feeding and increased paleness for one year. Pancytopenia with severe anemia was present along with 19% reactive/atypical cells in peripheral blood smear suggesting acute leukemia. However, bone marrow aspiration and biopsy showed features of megaloblastic anemia. Vitamin B12 level measured was very low and treatment with cyanocobalamin caused drastic improvement in the child's condition.
儿童维生素 B12 缺乏可导致巨幼细胞性贫血、生长不良和感染风险增加。它是骨髓抑制的一个重要可逆转原因,在发病时可模仿血液系统恶性肿瘤。因此,在疑似急性白血病的病例中应将其视为鉴别诊断。我们报告了一例 14 个月大的儿童,他表现出非典型的维生素 B12 缺乏。他有一年的慢性发热、食欲减退和面色苍白。全血细胞减少,严重贫血,外周血涂片有 19%的反应性/非典型细胞,提示急性白血病。然而,骨髓抽吸和活检显示巨幼细胞性贫血的特征。维生素 B12 水平很低,用氰钴胺素治疗后患儿病情急剧改善。