Vitamin B12 deficiency in exclusively breastfed infants is an important problem in developing countries. Vitamin B12 deficiency is associated with a wide spectrum of clinical manifestations. Few cases of vitamin B12 deficiency have been reported as the cause of infantile spasms. We report the case of a 6-month-old boy diagnosed with infantile spasms associated with vitamin B12 deficiency caused by nutritional inadequacy in the mother. He was observed to have head nods and flexor limbs spasms which appeared in clusters. Psychomotor development was normal. The serum vitamin B12 level was low and results of electroencephalography (EEG) indicated modified hypsarrhythmia. His symptoms resolved after synthetic adrenocorticotropic hormone (ACTH) and vitamin B12 treatment. The EEG was completely normal after the first month and sixth month of treatment. In addition to ACTH and vitamin B12 treatment, following antiepileptic drug treatment was not initiated. During 21 months’ follow up he is seizure-free and his neurological development is age-appropriate. This case of a 6 month-old infant with infantile spasms due to vitamin B12 deficiency seems to be a striking because of only with vitamin B12 and ACTH treatment the patient became seizure-free. Vitamin B12 deficiency may be a treatable cause of infantile spasms and should be considered in the associated cause of infantile spasms especially if nutritional inadequacy in the mother.
Vitamin B 12 Deficiency ; Infants

No abstract available.
Hand* ; Hyperpigmentation* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

No abstract available.
Anemia* ; Gastrectomy* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

PURPOSE: Vitamin B12 (VB12) deficiency is an inevitable sequela of a total gastrectom, which results in general symptoms, including easy fatigue, and hematological, neurological, and gastrointestinal complications. Especially in cases of neurological injury, it may be irreVersible if the timely treatment is delayed. Therefore the early diagnosis and treatment is essential. However, no guidelines exist for the incidence or treatments. METHODS: We investigated the symptoms and serum VB12 concentrations of 296 patients who underwent a total gastrectomy for a gastric malignancy. We defined 200~300 pg/ml as the mild decrease group, under 200 pg/ml as the severe decrease group, and over 300 pg/ml as the normal limit. RESULTS: The cumulative incidence of VB12 deficiency were 5.1, 11.2, 29.9, 44.7, 64.5% at 6 month, 1, 2 and 3 years, and at 4 or more years, respectively. The 90% of patients reported at least 1 symptom. The group under 200 pg/ml was supplemented at 1 month intervals; 10 of the 16 patients (63%) had their VB12 elevated to above 300 pg/ml. The group between 200~300 pg/ml was supplemented at 1 or 3 month intervals; 21 out of 23 (91%), and 12 out of 15 patients (80%) had their B12 elevated to above 300 pg/ml at the 1 and 3 month intervals, respectively, but with no statistical significance. CONCLUSION: The group with a V12 under 200 pg/ml should be supplemented 6 times, at 1 month intervals, regardless of the symptom presentation, and when the rechecked serum VB12 level has been increased above 300 pg/ml, it should be supplemented at 3 month intervals. In the group with a VB12 between 200 and 300 pg/ml, the VB12 should be supplemented at 3 month intervals if the symptom is present, and the asymptomatic group should be observed.
Early Diagnosis ; Fatigue ; Gastrectomy* ; Humans ; Incidence* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

No abstract available.
Brain* ; Cerebral Infarction ; Hyperhomocysteinemia* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

PURPOSE: The most common metabolic defect appearing following a gastrectomy is anemia. Two types have been identified: One is related to a deficiency in iron and the other is related to an impairment in vitamin B12 metabolism. The purpose of this study is to evaluate the incidence and treatment of vitamin B12 deficiency after a total gastrectomy. MATERIALS AND METHODS: Serum vitamin B12 concentrations were measured in 128 patients who had undergone a total gastrectomy. The group with a serum concentration under 200 pg/ml was supplemented at one-month intervals with Actinamide and five-six months later, serum concentrations of the vitamin B12 were rechecked. RESULTS: The group with vitamin B12 under 200 pg/ml was 61 (47.6%) of the 128 patients who had undergone a total gastrectomy. In this group, the cumulative incidences of vitamin B12 deficiency were 7.0, 23.4, 33.6, 39.1, 41.4, and 47.7% at 6 months, 1, 2, 3, 4, and 5 or more years, respectively. The treated group with vitamin B12 under 200 pg/ml had 36 (28.17%) of the 128 patients. The 16 of those cases with vitamin B12 levels of 100~150 pg/ml were supplemented 5.21 times and the vitamine B12 was elevated to above 650 pg/ml. The other 20 cases with an average of vitamin B12 levels of 150~200 pg/ml were supplemented an average of 4.75 times, and the vitamin B12 was elevated to above 780 pg/ml. CONCLUSION: It is necessary to supplement vitamin B12 even 1 year later after a total gastrectomy. The group with vitamin B12 under 200 pg/ml was supplemented 5~6 times at one-month intervals with Actinamide 1,000microgram IM injections and reached normal levels.
Anemia ; Gastrectomy* ; Humans ; Incidence ; Iron ; Metabolism ; Stomach Neoplasms* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Vitamin B12 deficiency has long been known to present with various neurological manifestations, but only rarely presents as movement disorders, especially in adults. We present the case of a 30-year-old vegan male presenting with tremors on both legs when standing which was relieved by vitamin B12 supplementation. To the best of our knowledge, this is the first documented case of slow orthostatic tremor or pseudo-orthostatic tremor caused by vitamin B12 deficiency.
Vitamin B 12 Deficiency ; Vitamin B 12 ; Vegans ; Movement Disorders ; Tremor ; Electromyography

Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.
Anemia ; Anemia, Iron-Deficiency* ; Bone Marrow ; Erythrocyte Indices ; Erythrocytes ; Iron* ; Masks ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.
Anemia ; Anemia, Iron-Deficiency* ; Bone Marrow ; Erythrocyte Indices ; Erythrocytes ; Iron* ; Masks ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

Megaloblastic anemia induced by Vitamin B12 deficiency is a disorder caused by impaired DNA synthesis. It has been previously thought to be rare in children, however, recent studies suggest that this condition is more common than previously recognized. Deficiency can lead to a wide spectrum of hematologic and neuropsychiatric disorders. Especially in children, it often presents with nonspecific manifestations, such as developmental delay, irritability, weakness, and failure to thrive. Early diagnosis and prompt treatment might resolve these complications, but permanent neurologic damage may have already occurred. We experienced two cases of Megaloblastic Anemia induced by Vitamin B12 deficiency and report them with a brief review of the literature.
Anemia, Megaloblastic* ; Child* ; DNA ; Early Diagnosis ; Failure to Thrive ; Humans ; Megaloblasts* ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*