Neuropsychological Profiles of Children Following Vitamin B12 Deficiency During Infancy: A Case Series

Previous studies investigating long-term outcomes in children following vitamin B12 deficiency during infancy have been limited to IQ or clinical observation. This paper seeks to describe comprehensive neuropsychological profiles in a case series of school-aged children who were treated for infantile vitamin B12 deficiency. This was a retrospective case series of seven children who were treated for vitamin B12 deficiency during infancy and aged 5 to 16 years at the time of testing. While most children had age-expected intellectual performance, the distribution of the sample was skewed to the lower end of the normal range. Furthermore, children were found to have impairments in a number of neuropsychological domains, most common were attention and memory, followed by executive function. These results suggest that while neurological symptoms quickly resolve following treatment, these effects on early brain development may disrupt brain maturation and have the potential to impact on later development.

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Faculty Opinions recommendation of Association between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725315390.793536965 ◽

2017 ◽

Author(s):

Peter Kahrilas

Keyword(s):

Systematic Review ◽

Vitamin B12 ◽

Meta Analysis ◽

Vitamin B12 Deficiency ◽

B12 Deficiency

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S2084 Cyanocobalamin Nasal Spray as an Alternative Treatment of Vitamin B12 Deficiency Related to Long Term use of Proton Pump Inhibitors in the Institutionalized Elderly

Gastroenterology ◽

10.1016/s0016-5085(10)61456-4 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-316

Author(s):

Nancy Rozgony ◽

Chengshun Fang

Keyword(s):

Vitamin B12 ◽

Nasal Spray ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Alternative Treatment ◽

Vitamin B12 Deficiency ◽

Institutionalized Elderly ◽

B12 Deficiency

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Analiza obrazu klinicznego niedokrwistości z niedoboru witaminy B12 u dzieci

Nowa Pediatria ◽

10.25121/np.2019.23.1.40 ◽

2019 ◽

Vol 23 (1) ◽

Author(s):

Aleksandra Pankiewicz ◽

Anna Adamowicz-Salach ◽

Marek W. Karwacki ◽

Katarzyna Pawelec ◽

Katarzyna Albrecht ◽

...

Keyword(s):

Vitamin B12 ◽

Metabolic Pathways ◽

Essential Role ◽

Vitamin B12 Deficiency ◽

Neurological Damage ◽

Laboratory Findings ◽

Delay In Diagnosis ◽

B12 Deficiency ◽

Late Manifestation

Diagnosis of vitamin B12 deficiency could be difficult due to various and rather unspecific symptoms and often late manifestation in hematological findings. B12 has a crucial role as cofactor of many metabolic pathways and has essential role in many processes such as DNA synthesis, neuron myelination and gluconeogenesis. Blood smear has a huge role in early diagnosis and should be performed. B12 deficiency is not very common, however could be underestimated especially in developing countries. In children main cause of deficiency is exclusively breastfeeding by vitamin B12 depleted mothers. Consequences of low intake in children are more severe than in adults, because of lower liver storage. Early detection and treatment is very important, because long term deficiency could result in persistent neurological damage. Coexistence iron or folate deficiencies could result delay in diagnosis. In this article different manifestation and laboratory findings in group of children with B12 deficiency is described.

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Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-3754 ◽

2016 ◽

Vol 101 (4) ◽

pp. 1754-1761 ◽

Cited By ~ 120

Author(s):

Vanita R. Aroda ◽

Sharon L. Edelstein ◽

Ronald B. Goldberg ◽

William C. Knowler ◽

Santica M. Marcovina ◽

...

Keyword(s):

Vitamin B12 ◽

Prevention Program ◽

Diabetes Prevention ◽

Vitamin B12 Deficiency ◽

Diabetes Prevention Program ◽

Open Label ◽

Metformin Group ◽

B12 Deficiency ◽

Outcomes Study

Abstract Context: Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use. Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). Design: Secondary analysis from the DPP/DPPOS. Participants were assigned to the placebo group (PLA) (n = 1082) or the metformin group (MET) (n = 1073) for 3.2 years; subjects in the metformin group received open-label metformin for an additional 9 years. Setting: Twenty-seven study centers in the United States. Patients: DPP eligibility criteria were: elevated fasting glucose, impaired glucose tolerance, and overweight/obesity. The analytic population comprised participants with available stored samples. B12 levels were assessed at 5 years (n = 857, n = 858) and 13 years (n = 756, n = 764) in PLA and MET, respectively. Interventions: Metformin 850 mg twice daily vs placebo (DPP), and open-label metformin in the metformin group (DPPOS). Main Outcome Measures: B12 deficiency, anemia, and peripheral neuropathy. Results: Low B12 (≤ 203 pg/mL) occurred more often in MET than PLA at 5 years (4.3 vs 2.3%; P = .02) but not at 13 years (7.4 vs 5.4%; P = .12). Combined low and borderline-low B12 (≤ 298 pg/mL) was more common in MET at 5 years (19.1 vs 9.5%; P < .01) and 13 years (20.3 vs 15.6%; P = .02). Years of metformin use were associated with increased risk of B12 deficiency (odds ratio, B12 deficiency/year metformin use, 1.13; 95% confidence interval, 1.06–1.20). Anemia prevalence was higher in MET, but did not differ by B12 status. Neuropathy prevalence was higher in MET with low B12 levels. Conclusions: Long-term use of metformin in DPPOS was associated with biochemical B12 deficiency and anemia. Routine testing of vitamin B12 levels in metformin-treated patients should be considered.

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