Varicella zoster virus-induced hemolytic crisis in an infant with severe vitamin B 12 deficiency.
BACKGROUND
Vitamin B 12 deficiency is an uncommon disorder in infancy. Most cases are because of maternal deficiency resulting from insufficient storage and/or reduced intake and are generally seen in exclusively breast-fed infants. Accentuation of the hemolytic process has never been described in association with Varicella Zoster Virus (VZV) infections.


METHODS
We describe a 9-months-old breast-fed infant with megaloblastic anemia secondary to maternal vitamin B 12 deficiency. He presented severe pancytopenia and regression of motor functions and developed hemolytic crisis during a VZV infection.


CONCLUSIONS
Nutritional cobalamin deficiency should be considered in anemic infants with a history of prolonged exclusive breastfeeding and delayed developmental milestones. VZV infection can trigger a hemolytic process in infants with severe megaloblastic anemia secondary to B12 deficiency. A normal mean corpuscular volume does not rule out megaloblastic anemia, when the condition is combined with severe hemolysis.
Lombardi
Francesca
F
UOC of Pediatrics, AO Carlo Poma, Pieve di Coriano, Mantova, Italy. francesca.lombardi@virgilio.it
Quitadamo
Anna Lucia
AL
Notarangelo
Lucia Dora
LD
Pelizzoni
Alessandra
A
Accorsi
Paola
P
Olivetti
Franco
F
Schumacher
Richard Fabian
RF
D006461:Hemolysis; D006562:Herpes Zoster / Q000628:therapy / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000472:pathogenicity*; D006801:Humans; D007223:Infant; D008297:Male; D010198:Pancytopenia / Q000628:therapy / Q000821:virology*; D016896:Treatment Outcome; D014806:Vitamin B 12 Deficiency / Q000150:complications*