Nutritional B12 Deficiency in Infants of Vitamin B12-Deficient Mothers

2011 ◽  
Vol 81 (5) ◽  
pp. 328-334 ◽  
Author(s):  
Oya Halicioglu ◽  
Sezin Asik Akman ◽  
Sumer Sutcuoglu ◽  
Berna Atabay ◽  
Meral Turker ◽  
...  
Keyword(s):  
Megaloblastic Anemia ◽  
Maternal Diet ◽  
Clinical Manifestations ◽  
Serum Vitamin ◽  
Failure To Thrive ◽  
Clinical Findings ◽  
Vitamin B ◽  
Animal Products ◽  
Hematological Evaluation ◽  
Nutritional Vitamin

Aim: Nutritional vitamin B12 deficiency in infants may occur because the maternal diet contains inadequate animal products. Clinical presentations of the infants who had nutritional vitamin B12 deficiency were analyzed in this study. Subjects and Methods: Patients with nutritional vitamin B12 deficiency were enrolled in the study between 2003 and 2010. The diagnosis was based on a nutritional history of mothers and infants, clinical findings, hematological evaluation, and low level of serum vitamin B12. Results: Thirty children aged 1 - 21 months constituted the study group. Poverty was the main cause of inadequate consumption of animal products of the mothers. All infants had predominantly breastfed. The most common symptoms were developmental delay, paleness, apathy, lethargy, anorexia, and failure to thrive. Hematological findings were megaloblastic anemia (83.3 %), thrombocytopenia (30 %), and severe anemia (13.3 %). All of the mothers had low serum B12 levels; eight of them had megaloblastic anemia. Conclusion: The unusual clinical manifestations of vitamin B12 deficiency may also be seen apart from neurological and hematological findings. Nutritional vitamin B12 deficiency due to maternal deficiency might be a serious health problem in infants. Therefore, screening and supplementation of pregnant and lactating women to prevent infantile vitamin B12 deficiency should be considered.

scholarly journals Plasma total homocysteine status of vegetarians compared with omnivores: a systematic review and meta-analysis

2013 ◽  
Vol 109 (5) ◽  
pp. 785-794 ◽  
Author(s):  
Derek Obersby ◽  
David C. Chappell ◽  
Andrew Dunnett ◽  
Amalia A. Tsiami
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Vitamin B ◽  
Elevated Plasma ◽  
Cross Sectional ◽  
Animal Products ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Plasma Total Homocysteine

There is strong evidence indicating that elevated plasma total homocysteine (tHcy) levels are a major independent biomarker and/or a contributor to chronic conditions, such as CVD. A deficiency of vitamin B12can elevate homocysteine. Vegetarians are a group of the population who are potentially at greater risk of vitamin B12deficiency than omnivores. This is the first systematic review and meta-analysis to appraise a range of studies that compared the homocysteine and vitamin B12levels of vegetarians and omnivores. The search methods employed identified 443 entries, from which, by screening using set inclusion and exclusion criteria, six eligible cohort case studies and eleven cross-sectional studies from 1999 to 2010 were revealed, which compared concentrations of plasma tHcy and serum vitamin B12of omnivores, lactovegetarians or lacto-ovovegetarians and vegans. Of the identified seventeen studies (3230 participants), only two studies reported that vegan concentrations of plasma tHcy and serum vitamin B12did not differ from omnivores. The present study confirmed that an inverse relationship exists between plasma tHcy and serum vitamin B12, from which it can be concluded that the usual dietary source of vitamin B12is animal products and those who choose to omit or restrict these products are destined to become vitamin B12deficient. At present, the available supplement, which is usually used for fortification of food, is the unreliable cyanocobalamin. A well-designed study is needed to investigate a reliable and suitable supplement to normalise the elevated plasma tHcy of a high majority of vegetarians. This would fill the gaps in the present nutritional scientific knowledge.

scholarly journals Holotranscobalamin – An Early Marker for Laboratory Diagnosis of Vitamin B12 Deficiency

2009 ◽  
Vol 03 (01) ◽  
pp. 7
Author(s):  
Wolfgang Herrmann ◽  
Rima Obeid ◽  
◽  
Keyword(s):  
At Risk ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Laboratory Diagnosis ◽  
Total Serum ◽  
Vitamin B ◽  
Active Portion ◽  
Negative Balance

Vitamin B12deficiency is widespread. Among the population groups at risk are older people, vegetarians, pregnant women and patients with renal or intestinal diseases. The neurological symptoms of vitamin B12deficiency are unspecific and can be irreversible. Early detection is therefore important. This article reviews the diagnostic performance of the different laboratory markers for vitamin B12status. Total serum vitamin B12is a relatively insensitive and unspecific biomarker of deficiency that does not reflect recent variations in cobalamin status. Holotranscobalamin (holoTC), the metabolically active portion of vitamin B12, is the earliest laboratory parameter that becomes decreased in case of a vitamin B12negative balance. Concentration of methylmalonic acid (MMA) is a functional vitamin B12marker that will increase when the vitamin B12stores are depleted. Isolated lowering of holoTC shows vitamin B12depletion (negative balance), while lowered holoTC plus elevated MMA (and homocysteine) indicates a metabolically manifested vitamin B12deficiency, although there still may be no clinical symptoms. The diagnostic use of holoTC allows the initiation of therapeutic measures before irreversible neurological damage develops. Because the clinical manifestations of vitamin B12deficiency are unspecific, people at risk should be identified and should regularly test their holoTC with or without MMA.

Effects of a Nutritional Supplement Fortified with Vitamin B-12 on Well Nourished, Free-Living Elderly Subjects

2006 ◽  
Vol 76 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Sandra Hirsch ◽  
Laura Leiva ◽  
Pía de la Maza ◽  
Vivian Gattás ◽  
Gladys Barrera ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Serum Vitamin ◽  
The Elderly ◽  
Nutritional Supplement ◽  
Elderly Subjects ◽  
Control Group ◽  
Vitamin B ◽  
Free Living ◽  
Healthy Elderly ◽  
Vitamin B 12

Vitamin B-12 deficiency is prevalent among the elderly population but it is often unrecognized because the clinical manifestations are not present. Objective: To evaluate the effects of a nutritional supplement fortified with vitamin B-12 on well nourished, free-living elderly subjects. Patients and methods: Healthy elderly subjects attending two of four clinics were allocated to receive, over six months’ duration, a nutritional supplement with 3.8 µg of vitamin B-12. Subjects attending the other two clinics served as controls. Serum vitamin B-12 levels were measured at baseline and 6 months after the supplementation was started. Results: After 6 months of consuming the supplement fortified with vitamin B-12, serum B-12 concentration increased from 350.1 ± 166.5 pmol/L to 409.0 ± 166.1 and decreased in the control group from 319.4 ± 129.1 to 290.1 ± 135.7 (ANOVA, p < 0.005). Conclusion: A supplementation with 3.8 µg /day of vitamin B-12 led to significant improvements in the serum concentrations of vitamin B-12 in older persons.

scholarly journals Reporte de un probable caso de Hemoglobina S / Talasemia Beta.

2013 ◽  
Vol 15 (3) ◽  
pp. 173
Author(s):  
John RAMÍREZ CUENTAS ◽  
Olga LIZAMA OLAYA ◽  
Josilú MARTÍNEZ LA ROSA ◽  
Mercy JHONG OLIVERA ◽  
Eduardo SALAZAR LINDO
Keyword(s):  
Cell Morphology ◽  
Clinical Presentation ◽  
Clinical Laboratory ◽  
Reticulocyte Count ◽  
Clinical Manifestations ◽  
Electrophoretic Analysis ◽  
Clinical Findings ◽  
Red Cell ◽  
Careful Observation ◽  
Hematological Evaluation

We report the case of a patient with Hemoglobin S / Thalassemia. It is feasible to recognize this infrequent disease by its clinical presentation and the aid of clinical laboratory . On this patient, the diagnosis was established based on the clinical findings, hematological evaluation (with careful observation of the red cell morphology and reticulocyte count) and electrophoretic analysis of hemoglobin. We discusse the physiopathology, clinical manifestations, treatment and alternative of prevention of this disease.

Severe Megaloblastic Anemia due to Nutritional Vitamin B12Deficiency

1969 ◽  
Vol 42 (4) ◽  
pp. 247-253 ◽  
Author(s):  
R.B. Ledbetter, Jr. ◽  
E. del Pozo
Keyword(s):  
Megaloblastic Anemia ◽  
Vitamin B ◽  
Nutritional Vitamin

scholarly journals Metformin Use and Vitamin B12 Deficiency in Patients with Type-2 Diabetes Mellitus

2016 ◽  
Vol 3 (1) ◽  
pp. 67 ◽  
Author(s):  
Singh Jeetendra ◽  
Baheti Tushar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Megaloblastic Anemia ◽  
Serum Vitamin ◽  
Cost Effective ◽  
Vitamin B ◽  
Average Dose ◽  
Annual Screening

Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B<sub>12</sub> which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B<sub>12</sub> level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of &gt;1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B<sub>12</sub> level also increases. Considering cost factor for annual screening, vitamin B<sub>12</sub> supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B<sub>12</sub> and hence are not of much therapeutic use in treatment of B<sub>12</sub> deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

Serum Vitamin B12 Concentrations among Mothers and Newborns and Follow-up Study to Assess Implication on the Growth Velocity and the Urinary Methylmalonic Acid Excretion

2009 ◽  
Vol 79 (56) ◽  
pp. 297-307 ◽  
Author(s):  
Laila Hussein ◽  
Sahar Abdel Aziz ◽  
Salwa Tapouzada ◽  
Boehles
Keyword(s):  
Early Diagnosis ◽  
Growth Velocity ◽  
Methylmalonic Acid ◽  
Post Partum ◽  
Serum Vitamin ◽  
Vitamin B ◽  
Postnatal Life ◽  
Negative Consequences ◽  
Metabolic Marker ◽  
Biochemical Measurement

Objective:Cobalamin (B12) deficiency has been reported in infants born to mothers with low cobalamin intake. Early diagnosis of vitamin B12 deficiency in infants is critical for the prevention of neurobehavioral disorders. We investigated the relationship between serum vitamin B12 level in newborns and in their healthy mothers who consumed an omnivorous diet. Anthropometry was studied longitudinally to assess the growth velocity of the infants. Urinary methylmalonic acid (MMA) excretion of 6-month old infants was compared retrospectively as the biomarker correlated with the initial serum vitamin B12 concentrations. Methods: Serum cobalamin and blood hemoglobin were determined in 84 pairs of newborns and their mothers. Urinary MMA excretion was measured in the same subjects during the first 6 months of the post partum period. Results: At birth, median serum cobalamin levels were 152.0 pmol/L in the mothers and 296.6 pmol/L in the newborns. Maternal and neonatal serum cobalamin levels had no effect on growth velocity during the first six months of postnatal life. Serum maternal and neonatal cobalamin levels were inversely associated with urinary MMA excretion. Conclusion: Early diagnosis of vitamin B12 status in neonates and infants is crucial, particularly in nutritionally deprived areas. Biochemical measurement of plasma cobalamin or its metabolic marker MMA is highly recommended. Urinary MMA measurement in cobalamin diagnostics provides an advantage in that blood sampling is not required. A vitamin B12 taskforce should be created to alleviate vitamin deficiency and its negative consequences.

КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ ПИЩЕВЫХ АЛЛЕРГЕНОВ ЖИВОТНОГО ПРОИСХОЖДЕНИЯ

2019 ◽  
Author(s):  
A.N. Pampura ◽  
E.E. Varlamov
Keyword(s):  
Clinical Manifestations ◽  
Red Meat ◽  
Cross Reactivity ◽  
Allergic Reactions ◽  
Essential Nutrients ◽  
Animal Products ◽  
Food Animal ◽  
Mammalian Meat

Продукты животного происхождения обладают наиболее сбалансированным комплексом необходимых нутриентов, поэтому их включение в пищевой рацион оправданно в различные возрастные периоды. Клинические проявления аллергии к данным продуктам крайне разнообразны. Одним из ключевых аспектов обозначенной проблемы является диагностика и оценка вероятности развития перекрестной реактивности. К пищевым продуктам животного происхождения, наиболее часто индуцирующим симптомы, относятся коровье молоко, куриное яйцо, рыба, моллюски, ракообразные, мясо млекопитающих. В представленной статье изложены данные об основных классах пищевых аллергенов животного происхождения, индуцирующих развитие перекрестных аллергических реакций. Описаны синдромы, связанные с перекрестной реактивностью: птица-яйцо , кошка-свинина , рыба-курица и -Gal-синдром/ синдром красного мяса .Animal foods products contain the most balanced complex of essential nutrients. The clinical manifestations of allergy to these products are varied. Key aspect of this problem is diagnostics and assessment of cross-reactivity. The food animal products that more often induce symptoms include cows milk, hens egg, fish, mollusks, crustaceans, mammalian meat. Data on the main classes of food animal allergens inducing the development of cross-allergic reactions as well as syndromes associated with cross-reactivity like bird-egg , cat-pork , fish-chicken and a-Gal-syndrome/ red meat syndrome are described in this article.

Scabies: A Neglected Global Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Joseph M. Lam ◽  
Kin F. Leong
Keyword(s):  
English Language ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sarcoptes Scabiei ◽  
Clinical Findings ◽  
Effective Control ◽  
Search Term ◽  
Skin Contact ◽  
Intense Pruritus ◽  
Meta Analyses

Background: Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. Objective: The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. Methods: A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Conclusion: Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

scholarly journals Masked vitamin B12 and folate deficiency in the elderly

1985 ◽  
Vol 54 (3) ◽  
pp. 613-619 ◽  
Author(s):  
G. M. Craig ◽  
C. Elliot ◽  
K. R. Hughes
Keyword(s):  
Clinical Investigation ◽  
Binding Capacity ◽  
Serum Vitamin ◽  
The Elderly ◽  
Folate Deficiency ◽  
Significant Negative Correlation ◽  
Serum Folate ◽  
Fe Deficiency ◽  
Vitamin B ◽  
Geriatric Unit

1. A high incidence of vitamin B12 or folate deficiency, or both, may be found in the elderly, particularly those in hospital. This report concerns fifty cases detected in an inner-city-area geriatric unit during the course of routine clinical investigation. The majority had none of the classical haematological signs of vitamin B12 or folate deficiency, and all the patients reported had a mean corpuscular volume (MCV) of less than 100 fl.2. There was a significant negative correlation between the MCV and the erythrocyte folate (P< 0.01), supporting earlier published work using a low serum folate as an index of folate deficiency.3. There was no correlation between the MCV and the serum vitamin B12. Published work differs on this point.4. Serum iron, total Fe-binding capacity and percentage Fe saturation results were available in forty patients in this series. There was a significant positive correlation between the serum Fe and the MCV (P<0.01) and 34% of patients had haematological evidence of Fe deficiency. In the majority, however, there was no evidence that associated Fe deficiency had masked the haematological signs of vitamin B12 or folate deficiency.5. More attention should be paid to the problem of ‘masked’ vitamin B12 and folate deficiency in the elderly. There is a case for routine screening of the elderly for vitamin B12 and folate deficiency irrespective of the MCV.

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