Vitamin B12 deficiency in infants is a serious concern due to its role in neurological development and
hematopoiesis. This deficiency often arises from inadequate intake, necessitating early diagnosis to
prevent enduring neurological consequences.
We present the case of a 14-month-old girl exclusively breastfed until her presentation with symptoms
of asthenia and psychomotor regression. Clinical examination revealed macrocephaly, peripheral
hypotonia, and abolished reflexes. Laboratory tests identified macrocytic anemia, neutropenia, and
elevated homocysteine levels. Vitamin B12 levels were significantly low. Investigations on the mother
showed no anaemia and a vitamin B12-level at the lower range of normal. The child received
intramuscular vitamin B12 and well-diversified diet. The evolution was favourable with normal
examination at the age of 18 months old.
This case underscores the importance of considering vitamin B12 deficiency in breastfed infants with
neurological and hematological abnormalities, even when maternal vitamin B12 levels appear normal.
Long-term neurological outcomes remain uncertain, emphasizing the need for vigilance in diagnosis
and management.
Author(s): Wiem Barbaria*, HanĂƒÂ¨ne Landolsi, Antonio Guerrioui, Ichrak Khamassi
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