Tremors and thrombocytosis during treatment of megaloblastic anaemia.
In developing countries, a deficiency of cobalamine and folate contributes significantly to megaloblastic anaemia. Neurological observations in infants and young children with megaloblastic anaemia have included hypotonia, developmental regression, tremors and other abnormal movements. Following therapy with vitamin B12, coarse tremors occurred in six of 51 patients (12%) with megaloblastic anaemia. The tremors, which were noticed initially in the hands and feet, gradually became generalised and disappeared during sleep. They subsided within 5-11 days. Thirteen of 25 (52%) patients developed thrombocytosis between day 3 and week 5 of follow-up. In one child, the platelet count increased to >1300 x 10(9)/L. The importance of recognising these clinical findings during treatment of megaloblastic anaemia is emphasised.
Chandra
Jagdish
J
Division of Pediatric Hematology, Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India. jchandra55@yahoo.co.in
Jain
Vipul
V
Narayan
Shashi
S
Sharma
Sunita
S
Singh
Varinder
V
Batra
Sanjay
S
Dutta
A K
AK
D000749:Anemia, Megaloblastic / Q000150:complications* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005492:Folic Acid / Q000627:therapeutic use*; D005494:Folic Acid Deficiency / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007194:India; D007223:Infant; D010976:Platelet Count; D013922:Thrombocytosis / Q000209:etiology*; D014202:Tremor / Q000209:etiology*; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000188:drug therapy
D005492:Folic Acid; D014805:Vitamin B 12