title: Vitamin B12 deficiency: the great masquerader.
abstract: Vitamin B12 deficiency is rare in children, with nonspecific symptoms including failure to thrive, vomiting, anorexia, and neurologic changes with or without hematologic disturbances. The neuropathy can be severe and irreversible. We report four cases of children with B12 deficiency secondary to adult type pernicious anemia, a presumed transport protein abnormality, and a metabolic defect. All demonstrated neurologic compromise that improved after initiation of B12 therapy. Hematologic manifestations may be preceded by constitutional, gastrointestinal, or neurologic changes, and must raise concern for B12 deficiency. Therapy should be initiated promptly in this setting to prevent irreversible neuropathy.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Medical College of Wisconsin/Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dobrozsi
authors.forename: Veronica H
authors.initials: VH
authors.lastname: Flood
authors.forename: Julie
authors.initials: J
authors.lastname: Panepinto
authors.forename: J Paul
authors.initials: JP
authors.lastname: Scott
authors.forename: Amanda
authors.initials: A
authors.lastname: Brandow
mesh_terms: D000293:Adolescent; D000328:Adult; D000752:Anemia, Pernicious / Q000150:complications*; D002675:Child, Preschool; D005183:Failure to Thrive / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D014805:Vitamin B 12
keywords: intrinsic factor; pernicious anemia; vitamin B12