Oral manifestations in vitamin B12 deficiency patients with or without history of gastrectomy

Background: Homocystinuria is a rare metabolic disorder charcterised by excess homocysteine in the urine. Vitamin B12 deficiency has diverse cutaneous, nervous and ophthalmic manifestations. Objective: To report a case of homocystinuria masquerading as vitamin B 12 deficiency. Case: We hereby are presenting an interesting case of a 4 year old boy who was being treated for Vitamin B 12 deficiency on the basis of history of delayed milestone, abdominal pain and hyperpigmentation of skin which was diagnosed as homocystinuria. Conclusion: It is important to carry out ophthalmological examination in every case of megaloblastic anemia if associated with blurring of vision and mental retardation.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6554 Nepal J Ophthalmol 2012; 4 (8): 326-328

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Severe Anaemia during Late Pregnancy

Case Reports in Obstetrics and Gynecology ◽

10.1155/2012/485452 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Mahenaz Akhtar ◽

Ismail Hassan

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

Late Pregnancy ◽

Severe Anaemia ◽

Blood Transfusions ◽

Deficiency Anaemia ◽

History Of ◽

B12 Deficiency ◽

Folate And Vitamin B12 ◽

In Pregnancy

Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb) levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

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Oral manifestations of vitamin B12 deficiency

British Journal of Oral Surgery ◽

10.1016/s0007-117x(68)80014-9 ◽

1968 ◽

Vol 6 (2) ◽

pp. 137-140 ◽

Cited By ~ 16

Author(s):

J.M. Faccini

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

Oral Manifestations ◽

B12 Deficiency

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A case of carbamazepine-induced vitamin B12 deficiency and neuropathy

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20185178 ◽

2018 ◽

Vol 8 (1) ◽

pp. 166

Author(s):

Ilathamizhan Jayakumar ◽

Jayanthi Mathaiyan

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Lower Limbs ◽

Probability Method ◽

Drug Induced ◽

Family History Of Diabetes ◽

History Of ◽

B12 Deficiency

Drug induced Neuropathy is seen commonly in patients undergoing treatment with drugs like phenytoin, dapsone, isoniazid etc. Carbamazepine is a drug used in the treatment in the treatment of focal seizure, generalized tonic - clonic seizure and trigeminal neuralgia. It is presented a case of carbamazepine induced vitamin B12 deficiency and neuropathy. A 21 year old male presented to our hospital with complaints of history of slipping of footwear while walking, numbness, impairment of balance and unsteadiness of gait in both lower limbs. Detailed history revealed the patient was on treatment with carbamazepine for tonic - clonic seizure for three months. He is non- smoker, non -alcoholic, not on treatment with other drugs and there is no family history of diabetes mellitus/ sensory neuropathy. On examination power was normal on both lower limbs, vibration sensation was decreased in both lower limbs, sensation was reduced, joint position was affected in bilateral toe and ankle reflex was absent. Vitamin B12 level was found to be 83pg/ml. The patient was discontinued from carbamazepine and started on vitamin B12 therapy and the symptoms subsides slowly. Causality assessment done by WHO- UMC probability method and Naranjo Adverse Drug Reactions Probability Scale showed “Probable” association.

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Profile of Vitamin B12 Deficiency and Analysis of Contributory Factors among Inpatients in a Tertiary Care Hospital in Madurai, South India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/550 ◽

2020 ◽

Vol 7 (46) ◽

pp. 2674-2679

Author(s):

Vairapraveena Ramesh ◽

Sangeetha Ashokan ◽

Anu Sengottaiyan ◽

Vijay Anto James

Keyword(s):

Vitamin B12 ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Vitamin B12 Deficiency ◽

Cooking Methods ◽

Care Hospital ◽

Contributing Factors ◽

History Of ◽

B12 Deficiency

BACKGROUND It is well known that Vitamin B12 deficiency is common among vegetarians as Vitamin B12 is obtained predominantly from animal sources. However, recent reports show that Vitamin B12 deficiency is becoming more common among nonvegetarians too and surprisingly the major factor attributing to this is found to be due to dietary deficiency. We hypothesized that this could also be due to the type of non-vegetarian food consumed, cooking methods, type of utensil used, and other modifiable risk factors like smoking, alcohol and diseases causing Vitamin B12 deficiency. We wanted to assess the proportion of vegetarians and nonvegetarians with vit. B12 deficiency and analyse the contributing factors among inpatients with vitamin B12 deficiency in a tertiary care hospital in South India. METHODS This observational, prospective study was done between June and September 2019 & involved 200 Vitamin B12 deficiency patients in the age group of 20 - 50 years of both the genders. Patients were identified after reviewing their medical records and laboratory tests for MCV, MCH, MCHC, Hb & vitamin B12. A detailed history of their food habits, practices & other relevant factors was obtained using a questionnaire. Statistical analysis was done using Mann Whitney U test. RESULTS There was no statistical difference (p = 0.379) in the vitamin B12 levels among vegetarians and non-vegetarians. 54.6 % of participants consumed poultry, 32.5 % consumed fruits & vegetables less than 4 times a week, 36 % & 42 % consumed fried & boiled food, 58 % used ever-silver vessels for cooking, 70.6 % used packaged milk, 23 % consumed alcohol & 21 % were smokers. CONCLUSIONS Vitamin B12 deficiency is common both among vegetarians and non-vegetarians. Among non-vegetarians, deficiency is seen more with poultry eaters, packaged milk consumers, with fried / boiled method of cooking using ever-silver vessels. Alcoholism, caffeinated beverages, smoking, presence of other diseases like diabetes, hypertension, peptic ulcer, drug intake also contributes to Vitamin B12 deficiency. KEYWORDS Vitamin B12 Deficiency, Non-Vegetarians, Vegetarians, Contributing Factors

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RECOGNITION AND MANAGEMENT OF VITAMIN B12 DEFICIENCY: A REPORT OF 3 CASES WITH ORAL MANIFESTATIONS

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2020.04.215 ◽

2020 ◽

Vol 130 (3) ◽

pp. e155

Author(s):

ANDRÉ AZEVEDO DOS SANTOS ◽

PATRÍCIA TEIXEIRA DE OLIVEIRA ◽

ANA MIRYAM COSTA DE MEDEIROS ◽

PATRÍCIA GUERRA PEIXE ◽

ÉRICKA JANINE DANTAS DA SILVEIRA

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

Oral Manifestations ◽

B12 Deficiency

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Oral Manifestations of Vitamin B12 (Cobalamin) Deficiency: A Review

International Healthcare Research Journal ◽

10.26440/ihrj/0301.04.521066 ◽

2019 ◽

Vol 3 (1) ◽

pp. 9-15

Author(s):

Kanaparthi Alekhya ◽

Srikar Muppirala

Keyword(s):

Early Diagnosis ◽

Vitamin B12 ◽

Intrinsic Factor ◽

Cell Formation ◽

Vitamin B12 Deficiency ◽

Water Soluble ◽

Cobalamin Deficiency ◽

Oral Manifestations ◽

Populations At Risk ◽

B12 Deficiency

Vitamin B12, also known as cobalamin is a water soluble vitamin. It is critical for normal functioning of the red blood cell formation and nervous system. It is a complex vitamin and it’s deficiency is known to be one of the commonest deficiency in Indian population particularly in elderly and in vegans as it requires castles intrinsic factor released by parietal cells in the stomach for its absorption. Vitamin B12 deficiency may also result from pernicious anemia, gastrectomy & intestinal malabsorption. It is often overlooked and may cause several oral, haematological, gastrointestinal, psychiatric and neurological manifestations. As it affects the oral mucosal tissues, early diagnosis of the manifestations may aid in diagnosing the underlying cause even before haematological examination. Hence, oral physicians should be vigilant enough to identify signs or symptoms of suspected vitamin deficiency in populations at risk. Early diagnosis is crucial for starting replacement therapy to avoid irreversible neurological damage. This article reviews the various oral manifestations of vitamin B12 deficiency and its management.

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55: The Risk of Vitamin B12 Deficiency is Low after Ileal Orthotopic Bladder Substitution

The Journal of Urology ◽

10.1016/s0022-5347(18)37317-8 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 15-15

Author(s):

Urs E. Studer ◽

Richard Aebischer ◽

Katharina Ochsner ◽

Werner W. Hochreiter

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

B12 Deficiency ◽

Bladder Substitution

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Bioavailability of Vitamin B12

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000041 ◽

2010 ◽

Vol 80 (45) ◽

pp. 330-335 ◽

Cited By ~ 28

Author(s):

Lindsay Helen Allen

Keyword(s):

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

The Elderly ◽

Radioactive Isotopes ◽

Animal Source Foods ◽

Dietary Requirements ◽

In Vivo Labeling ◽

B12 Deficiency ◽

Vitamin B12 Malabsorption

Vitamin B12 deficiency is common in people of all ages who consume a low intake of animal-source foods, including populations in developing countries. It is also prevalent among the elderly, even in wealthier countries, due to their malabsorption of B12 from food. Several methods have been applied to diagnose vitamin B12 malabsorption, including Schillings test, which is now used rarely, but these do not quantify percent bioavailability. Most of the information on B12 bioavailability from foods was collected 40 to 50 years ago, using radioactive isotopes of cobalt to label the corrinoid ring. The data are sparse, and the level of radioactivity required for in vivo labeling of animal tissues can be prohibitive. A newer method under development uses a low dose of radioactivity as 14C-labeled B12, with measurement of the isotope excreted in urine and feces by accelerator mass spectrometry. This test has revealed that the unabsorbed vitamin is degraded in the intestine. The percent bioavailability is inversely proportional to the dose consumed due to saturation of the active absorption process, even within the range of usual intake from foods. This has important implications for the assessment and interpretation of bioavailability values, setting dietary requirements, and interpreting relationships between intake and status of the vitamin.

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