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LETTER TO THE EDITOR
Year : 2019  |  Volume : 10  |  Issue : 2  |  Page : 75

Persistent diarrhea, hemolytic anemia, and splenohepatomegaly due to vitamin b12 deficiency in an infant


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication10-Jul-2019

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P.O.Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_24_19

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How to cite this article:
Al-Mendalawi MD. Persistent diarrhea, hemolytic anemia, and splenohepatomegaly due to vitamin b12 deficiency in an infant. J Appl Hematol 2019;10:75

How to cite this URL:
Al-Mendalawi MD. Persistent diarrhea, hemolytic anemia, and splenohepatomegaly due to vitamin b12 deficiency in an infant. J Appl Hematol [serial online] 2019 [cited 2019 Nov 21];10:75. Available from: http://www.jahjournal.org/text.asp?2019/10/2/75/262540

I read with great interest the case report by Kumar et al.[1] published in the October–December 2018 issue of the Journal of Applied Hematology. The authors reported a 6-month-old Indian child with persistent diarrhea, growth retardation, irritability, anorexia, anemia, and hepatosplenomegaly due to Vitamin B12 deficiency that responded to Vitamin B12 treatment.[1] The authors attributed that Vitamin B12 deficiency to the observation that the studied infant was exclusively breastfed without complementary feeds. However, they did not attempt to evaluate Vitamin B12 status in the mother and its correlation with Vitamin B12 status in her infant. The issue of Vitamin B12 deficiency in Indian infants and their mothers is really a matter of concern. Interestingly, the prevalence of Vitamin B12 deficiency in exclusively breastfed Indian infants aged 1–6 months infants was found to be alarmingly high (57%), while 46% of their mothers were deficient. There was a positive correlation between the Vitamin B12 levels of the infants and their mothers.[2] Hence, I assume that measuring serum Vitamin B12 in the mother of the studied infant was solicited. The case in question sent an important message to the practicing pediatricians to consider underlying Vitamin B12 deficiency in any infant presenting with protean manifestations. Although periconceptional folate supplementation is globally recommended and practiced, Vitamin B12 supplementation during early gestation and lactation has received little consideration, particularly in the developing countries.[3] I assume that the case in question sent additional sound message to the policy makers in India to take into consideration routine Vitamin B12 supplementation during early pregnancy and lactation to contain the burden and serious consequences of Vitamin B12 deficiency in pregnant and their infants.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
1. Kumar K J, Prudhvi S, Balaji K, Rahul R. Persistent diarrhea, hemolytic anemia, and splenohepatomegaly due to Vitamin B12 deficiency in an infant. J Appl Hematol 2018;9:148-50.  Back to cited text no. 1
    
2.
2. Mittal M, Bansal V, Jain R, Dabla PK. Perturbing status of vitamin B12 in Indian infants and their mothers. Food Nutr Bull 2017;38:209-15.  Back to cited text no. 2
    
3.
3. Obeid R, Murphy M, Solé-Navais P, Yajnik C. Cobalamin status from pregnancy to early childhood: Lessons from global experience. Adv Nutr 2017;8:971-9.  Back to cited text no. 3
    




 

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