title: Frequent Infections, Hypotonia, and Anemia in a Breastfed Infant.
abstract: Vitamin B12 deficiency may be responsible of serious hematologic and neurodevelopmental abnormalities. We report the case of an infant who was hospitalized because of recurrent infections, failure to thrive, hypotonia, and weakness. He was 8 months old and had been exclusively breastfed. Blood cell count showed pancytopenia with megaloblastic bone marrow. The serum IgG concentration was low. Vitamin B12 level was very low and associated with increased urinary methylmalonic acid. Cobalamin deficiency was caused by mother's unrecognized pernicious anemia. Vitamin B12 supply led to rapid clinical and hematologic improvement.
authors.affiliation: *Pediatrics Department, Hedi Chaker Hospital †Faculty of Medicine of Sfax ‡Hematology Laboratory, Habib Bourguiba Hospital, Sfax, Tunisia.
authors.forename: Fatma
authors.initials: F
authors.lastname: Kamoun
authors.forename: Rime
authors.initials: R
authors.lastname: Guirat
authors.forename: Fatma
authors.initials: F
authors.lastname: Megdich
authors.forename: Salma
authors.initials: S
authors.lastname: Ben Ameur
authors.forename: Choumous
authors.initials: C
authors.lastname: Kallel
authors.forename: Mongia
authors.initials: M
authors.lastname: Hachicha
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000209:etiology; D000749:Anemia, Megaloblastic / Q000209:etiology*; D000752:Anemia, Pernicious / Q000175:diagnosis* / Q000378:metabolism; D058070:Asymptomatic Diseases; D001942:Breast Feeding / Q000009:adverse effects*; D003141:Communicable Diseases / Q000209:etiology; D005183:Failure to Thrive / Q000209:etiology; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood / Q000652:urine; D008895:Milk, Human / Q000737:chemistry; D009123:Muscle Hypotonia / Q000209:etiology; D012008:Recurrence; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000209:etiology*
chemical_list: D007074:Immunoglobulin G; D008764:Methylmalonic Acid