[Subacute combined degeneration. A description of the case of a strictly vegetarian child].
BACKGROUND
Cyanocobalamin (vitamin B12) is an essential cofactor of various metabolic pathways. Lack of it leads to symptoms which may be constitutional, of skin or mucous membranes, hematological or neuropsychiatric disorders. Neurological involvement in adults has been well described and analyzed in the literature, however there are fewer cases of children. In the cases described in children the deficiency was related to maternal malnutrition, and socioeconomic and cultural problems. Since vegetarianism is a custom followed by different social groups we wish to draw attention to this as a cause of vitamin B12 deficiency and the neurological disorder this may cause.


METHODS
We describe the case of a 10 year old boy, a member of a religious community who were strict vegetarians. Over three months he developed: a cognitive disorder, pyramidal syndrome of his legs, involvement of the posterior spinal cord, peripheral motor and sensory alterations which, together with the complementary investigations, was found to be compatible with subacute combined degeneration due to vitamin B12 deficiency.


CONCLUSIONS
We draw attention to the clinical and laboratory aspects of this disorder and the importance of taking the possibility of this diagnosis into account in children with nutritional risk factors.
Cornejo
W
W
Universidad de Antioquia. Facultad de Medicina, Medellín, Antioquía, Colombia. williamco@epm.net.co
González
F
F
Toro
M E
ME
Cabrera
D
D
D002648:Child; D014676:Diet, Vegetarian / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019636:Neurodegenerative Diseases / Q000209:etiology* / Q000503:physiopathology; D009483:Neuropsychological Tests; D013116:Spinal Cord / Q000473:pathology; D013904:Thoracic Vertebrae; D014805:Vitamin B 12 / Q000378:metabolism; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology
D014805:Vitamin B 12
Degeneración combinada subaguda. Descripción de un caso en un niño vegetariano estricto.