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2022, Number 3

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Rev Cubana Pediatr 2022; 94 (3)

Different forms of presentation of megaloblastic anemia in the infant

Martínez PL, Núñez GA, García GA, López González-Molleda JC

Language: Spanish
References: 14
Page: 1-14
PDF size: 340.95 Kb.


ABSTRACT

Introduction: Megaloblastic anemia is a maturing disorder of the erythroid and myeloid precursors caused by deficiency of vitamin B12, folic acid, or both. It is uncommon in childhood and its prevalence is unknown because it is a rare disease.
Objective: To describe different forms of presentation of megaloblastic anemia in infants.
Presentation of cases: Two cases of infants are presented, in case 1 the mother had a precarious diet during pregnancy and lactation, and prolonged exclusive breastfeeding more than 6 months. The patient began to lose the skills gained in psychomotor development and presented severe neurological disorders, so it was considered that it was a progressive disease of the central nervous system. In case 2, in which exclusive breastfeeding was prolonged, thrombocytopenia appeared, so a malignant hematological disease was suspected.
Results: In both cases, after performing various tests to rule out neurological diseases (case 1) and hematological diseases (case 2), megaloblastic anemia was diagnosed due to vitamin B12 deficiency due to a decrease in intake and a borderline reserve in the breastfeeding mother. In both cases the symptoms disappeared with vitamin replacement therapy.
Conclusions: In the infant, megaloblastic anemia can occur in different clinical ways despite having the same cause, a deficit in intake and a low reserve of the mother during pregnancy and lactation.


REFERENCES

  1. Srinivas M, Ravali G. Rare Presentation of megaloblastic anemia: A case report. IJSS Cas Rep Rev. 2015;1(9):46-8. DOI: https://doi.org/10.17354/cr/2015/291.

  2. Martinez Perez L, Nuñez Garcia A, Forrellat Barrios M, Leon Ojeda NE, Lopez Gonzalez-Molleda JC. Trastornos neurológicos graves en el lactante con anemia megaloblástica. Presentación de caso. Rev Cubana hematol Inmunol Hemoter. 2018 [acesso 07/01/2018];34(1). Disponible en: www.revhematologia.sld.cu/index.php/ihi/article/view/542/773

  3. Green R, Datta-Mitra A. Megaloblastic Anemias: Nutritional and Other Causes. Med Clin North Am. 2017;101(2):297-317. DOI: 10.1016/j.mcna.2016.09.0133.

  4. Marin Castro MJ. Anemia megaloblástica, generalidades y su relación con el déficit neurológico. Arch Med (Manizales). 2019;19(2):420-8. DOI: https://doi.org/10.30554/archmed.19.2.2776.20194.

  5. Hawthorne S, Levy H. Can newborn screening for vitamin b 12 deficiency be incorporated into all newborn screening programs? J Pediatr. 2020;216:9-11.e1. DOI: 10.1016/j.jpeds.2019.08.0615.

  6. Alvarado Mata D, Morera Arguedas G. Anemia megaloblástica: una revisión bibliográfica. Rev Electrón Portal Medic.com. 2020 [acceso 08/01/2021];XV(15):773. Disponible en: https://www.revistaportalesmedicos.com/revista-medica/anemia-megaloblastica-una-revision-bibliografica/6.

  7. Verma D, Chandra J, Kumar P, Shukla S, Sengupta S. Efficacy of oral methylcobalamin in treatment of vitamin B12 deficiency anemia in children. Pediatr Blood Cancer. 2017;64(12). DOI: 10.1002/pbc.266987.

  8. Dubaj C, Czyz K, Furmaga W. Vitamin B 12 deficiency as cause of severe neurological symptoms in breast fed infants. A case report. Ital J Pediatr. 2020;46(1):40-4. DOI: 10.1186/s13052-020-0804-x8.

  9. Rosas M, Medici C, Lemes A, Cerisola A, Suarez P, Lombardo N, Tourreilles A, González G. Encefalopatía subaguda adquirida del lactante por deficiencia de vitamina B12 materna. Arch. Pediatr Urug. 2020;91(6). DOI: https://dx.doi.org/10.31134/ap.91.6.39.

  10. Forrellat M, Hernández P. Deficiencia de vitamina B12: ¿tratamiento oral o parenteral? Rev Cubana Hematol Inmunol Hemoter. 2009 [acceso 08/01/2021];25(1):1-8. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-0289200900010000110.

  11. Kvestad I, Hysing M, Shrestha M, Ulak M, Thorne-Lyman AL, Henjum S, et al. Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children. Am J Clin Nutr. 2017;105(5):1122-31. DOI: 10.3945/ajcn.116.14493111.

  12. Green R. Vitamin B(12) deficiency from the perspective of a practicing hematologist. Blood. 2017;129(19):2603-11. DOI: 10.1182/blood-2016-10-56918612.

  13. Venkatramanan S, Armata IE, Strupp BJ, Finkelstein JL. Vitamin B-12 and Cognition in Children. Adv. 2016;7(5):879-88. DOI: 10.3945/an.115.01202113.

  14. Kocaoglu C, Akin F, Caksen H, Böke SB, Arslan S, Aygün S. Cerebral atrophy in a vitamin B12 deficient infant of a vegetarian mother. J Health Popul Nutr. 2014 [acceso 08/01/2021];32(2):367-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC421697214.




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