Murat SÖKER, GÖZÜ Ayfer PİRİNÇÇİOĞLU, Ahmet YARAMIŞ, Mustafa TAŞKESEN, Selahattin KATAR

Neurological presentations of nutritional vitamin B12 defi ciency in 42 breastfed infants in Southeast Turkey

Amaç: Beslenme yetersizliğine bağlı vitamin B12 eksikliği gelişmemiş ve gelişmekte olan ülkelerde yaygın olup, çeşitli nörolojik sorunlara neden olmaktadır. Bu çalışmanın amacı vitamin B12 eksikliği tanısı ile izlenen süt çocuklarının nörolojik bulgularını ve laboratuvar sonuçlarını değerlendirmektir. Yöntem ve gereç: Çalışmaya 42 hasta alındı. Tüm hastaların klinik, fiziki ve nörolojik muayene sonuçları ve kısa süreli izlem sonuçları kaydedildi. Bulgular: Hastaların 24’ü (% 57) erkek ve 18’i (% 43) kız ve tanı sırasında ortalama yaşları 13,04 ± 5,68 ay idi. Hastaların çoğunun sadece anne sütü ile beslendiği ve annelerinin hayvansal protein içeren gıdalardan yeterince tüketmedikleri saptandı. En sık başvuru semptomları hipotoni (% 100), iştahsızlık (% 92,8), nörogelişimsel (% 85,7) ve sosyal gerilik (% 80,9) idi. Sonuç: Vitamin B12 eksikliği olan çocuklarda ciddi nörolojik ve hematolojik bulgular görülebilir. Erken tanı ve tedavi, hematolojik komplikasyonlar ve nörolojik etkilenme açısından önemlidir. Tanının gecikmesi (12 ay) durumunda nörolojik etkilenme geri dönüşümsüz olabilmektedir. Gebelik döneminde annelere vitamin B12 desteği ve süt çocuklarına tamamlayıcı besinlerin zamanında verilmesi nörolojik defisitlerin ve nörogelişimsel geriliğin oluşmasını önleyebileceğini düşünmekteyiz.

Güneydoğu Anadolu’da anne sütü ile beslenen ve vitamin B12 eksikliği saptanan çocuklarda nörolojik bulgular

Aim: Nutritional vitamin B12 deficiency is common in developing and underdeveloped countries and has a wide variety of neurological presentations. The aim of this study was to evaluate the neurological characteristics and laboratory results of infants with vitamin B12 deficiency. Materials and methods: A total of 42 infants were included in this study. All patients were evaluated for clinical, physical, and neurological abnormalities, and an attempt was made to obtain short-term neurologic follow-up. Results: Of 42 patients, 24 (57%) were boys and 18 (43%) were girls. The average age at diagnosis was 13.04 ± 5.68 months. Most of these infants were breastfed only and born from mothers with inadequate animal-derived protein consumption. Hypotonia (100%), anorexia (92.8%), neurodevelopmental (85.7%), and social (80.9%) retardation were the most present symptoms in all infants. Conclusion: Severe neurological and hematological findings may be found in children with vitamin B12 deficiency. Early diagnosis and treatment is crucial in cases of hematological complications and neurologic impairment. Neurologic impairment may be irreversible if the diagnosis is delayed beyond 12 months. We think that dietary management, such as nutritional support with vitamin B12 for the mothers during pregnancy and complementary food for infants, may prevent the neurological defi cits and neurodevelopmental retardation.

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