scholarly journals Unusual presentation of vitamin B12 deficiency in a 3 month old infant: presentation with hemolysis and thrombocytopenia

2020 ◽  
Vol 7 (8) ◽  
pp. 1816
Author(s):  
Poornima Shankar ◽  
Anil H.
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Well Being ◽  
The Body ◽  
Elevated Bilirubin ◽  
B12 Deficiency ◽  
Laboratory Investigations ◽  
Vitamin B12 Supplementation ◽  
Poor Weight Gain

A 3 month old infant exclusively breast fed presented with vomiting and poor weight gain with purpuric and echymotic patches all over the body. The child also had hyperpigmentation over knuckles and icterus. Laboratory investigations revealed severe dimorphic anemia with thrombocytopenia, elevated bilirubin and LDH levels and severe vitamin B12 deficiency. Following vitamin B12 supplementation there was improvement in well-being including feed tolerance, icterus resolved and in follow up lab studies there was improvement in hemoglobin and platelet counts along with reduced bilirubin levels. Through this case report we want to emphasize the possibility of vitamin B12 deficiency presenting as hemolytic anemia and psuedothrombotic microangiopathy.

scholarly journals Vitamin B12 Supplementation in Treating Major Depressive Disorder: A Randomized Controlled Trial

2013 ◽  
Vol 7 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Ehsan Ullah Syed ◽  
Mohammad Wasay ◽  
Safia Awan
Keyword(s):  
Treatment Group ◽  
Vitamin B12 ◽  
Controlled Trial ◽  
Vitamin B12 Deficiency ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Depressed Patients ◽  
B12 Deficiency ◽  
Vitamin B12 Supplementation

Background/Objective: Recent literature has identified links between vitamin B12 deficiency and depression.We compared the clinical response of SSRI-monotherapy with that of B12-augmentation in a sample of depressed patients with low normal B12 levels who responded inadequately to the first trial with the SSRIs. Methods: Patients with depression and low normal B12 levels were randomized to a control arm (antidepressant only) or treatment arm (antidepressants and injectable vitamin B12 supplementation). Results: A total of 199 depressed patients were screened. Out of 73 patients with low normal B12 levels 34 (47%) were randomized to the treatment group while 39 (53%) were randomized to the control arm. At three months follow up 100% of the treatment group showed at least a 20% reduction in HAM-D score, while only 69% in the control arm showed at least a 20% reduction in HAM-D score (p<0.001). The findings remained significant after adjusting for baseline HAM-D score (p=0.001). Conclusion: Vitamin B12 supplementation with antidepressants significantly improved depressive symptoms in our cohort.

scholarly journals Is Inflammation Status in Postbariatric Patients Predictive for Their Response to Vitamin B12 Supplementation Therapy?

2021 ◽  
Vol 105 (1-3) ◽  
pp. 397-401
Author(s):  
Sjaak Pouwels ◽  
Hendrika J.M. Smelt ◽  
Johannes F. Smulders
Keyword(s):  
Bariatric Surgery ◽  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Reactive Protein ◽  
Inflammatory Status ◽  
B12 Deficiency ◽  
Injection Regimen ◽  
Vitamin B12 Supplementation

Background Several studies indicate that there is a relationship between vitamin B12 levels and inflammatory status. Some studies showed a significantly correlation between vitamin B12 status and inflammation. The aim of this study is to investigate the influence of inflammatory status on the effect of different vitamin B12 supplementation regimes. Methods We selected patients with a vitamin B12 deficiency based on methylmalonic acid (MMA) levels. A moderate vitamin B12 deficiency was defined as an MMA blood level between ≥300 and 430 nmol/L. In included patients, C-reactive protein (CRP), leukocytes, serum vitamin B12, and MMA levels were measured at baseline and after 6 months of follow-up. Results A total of 63 patients were included, treated with 3, 6, or no intramuscular vitamin B12 injections. In the 6 intramuscular injections group, the presupplementation CRP levels significantly predicted the response in terms of vitamin B12 increase (P = 0.015). Also, there was a significant reduction in CRP levels (P = 0.03) after 6 injections. There was a significant correlation between presupplementation MMA and presupplementation CRP (r = 0.127, P = 0.049). Conclusion This study showed that presupplementation CRP levels significantly predicted the response on 6 intramuscular vitamin B12 injections in patients after bariatric surgery. Second, the 6 intramuscular injection regimen showed a significant reduction in CRP levels. Third, there was a significant correlation between MMA and presupplementation CRP. This might indicate that there is interplay between the vitamin B12 supplementation and inflammatory levels in patients after bariatric surgery.

Vitamin B12 Deficiency an Unusual Cause of Fever: A Case Report

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Shyama . ◽  
P. Kumar ◽  
Surabhi .
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Unusual Case ◽  
Vitamin B12 Deficiency ◽  
Bone Marrow Aspiration ◽  
Microcytic Anemia ◽  
Peripheral Smear ◽  
Erythroid Hyperplasia ◽  
B12 Deficiency ◽  
Vitamin B12 Supplementation

Introduction: An unusual case of a 19 year old female, presenting with fever, pallor and hepatosplenomegaly for one month. She had microcytic anemia on peripheral smear examination but her bone marrow aspiration & biopsy revealed a hypercelluar marrow with megaloblastic erythroid hyperplasia. Resolution of fever within 48 hours of Vitamin B12 supplementation, initiated in view of the megaloblastic bone marrow picture & low serumVitamin B12 level, suggests a causal association. Conclusion: Vitamin B12 deficiency seems to be an unusual cause of PUO (Pyrexia of unkown origin) which should be ruled out in every case of PUO.

scholarly journals Vitamin B12 deficiency: metabolic effects, clinical evaluation, and treatment

2019 ◽  
Vol 59 (2) ◽  
pp. 40 ◽  
Author(s):  
Synara Cavalcante Lopes ◽  
Daniel Duarte Gadelha ◽  
Manuela Dias de Carvalho ◽  
Virgínia Oliveira Fernandes ◽  
Renan Magalhães Montenegro Junior
Keyword(s):  
Insulin Resistance ◽  
Vitamin B12 ◽  
Neurological Disorders ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Water Soluble ◽  
Metabolic Effects ◽  
Pharmacological Treatments ◽  
B12 Deficiency ◽  
Composition Changes

Vitamin B12 is a water-soluble essential micronutrient, required by all the body cells. Its deficiency has been implicated not only in hematological and neurological disorders, but also in many metabolic processes, such as insulin resistance and body composition changes, which have aroused particular interest in recent years. This study reviews the physiology of vitamin B12 from its digestion and absorption to its distribution in tissues, metabolic effects and controversies regarding the diagnosis of deficiency, and to dietary and pharmacological treatments.

scholarly journals Prevalence of vitamin B12 deficiency among individuals with type 2 diabetes mellitus in a South Indian rural community

2018 ◽  
Vol 7 (2) ◽  
pp. 309 ◽  
Author(s):  
Shailendra D. ◽  
Rizwan Kalani ◽  
K. M. Venkat Narayan ◽  
Dorairaj Prabhakaran ◽  
Nikhil Tandon ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Rural Community ◽  
Odds Ratio ◽  
Complete Blood Count ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Oral Vitamin ◽  
South Indian ◽  
B12 Deficiency ◽  
Vitamin B12 Supplementation

Background: To estimate the prevalence of vitamin B12 deficiency in a rural south Indian community and to evaluate the association between metformin use and prevalent vitamin B12 deficiency in people with T2DM stratified by oral vitamin B12 supplementation.Methods: Using a cross sectional study design, a random sample of people with T2DM (N=438) was recruited from a rural community. Vitamin B12 deficiency was defined as serum B12 ≤200pg/ml. Data on metformin dose, duration of use, oral vitamin B12 supplementation, and diet were collected. Laboratory measurements included complete blood count, tests for hepatic, renal, and thyroid function, as well as serum vitamin B12 levels and HbA1c.Results: The prevalence of vitamin B12 deficiency in people with T2DM was 11.2% (95% Confidence Interval (CI) 8.2%-14.1%). The odds of vitamin B12 deficiency in patients receiving a metformin dose of 2 grams/day were 4 times higher compared to those receiving ≤1 gram/day, after adjusting for oral B12 supplementation (odds ratio 4.2;95% CI 1.5-11.8). The odds of vitamin B12 deficiency in those taking metformin and receiving oral vitamin B12 supplementation were lower compared to those on metformin and not receiving vitamin B12 supplementation (adjusted odds ratio 0.20; 95% CI 0.06-0.70).Conclusions: Vitamin B12 deficiency affects 1 in 10 people with T2DM, is associated with higher dose metformin use, and oral vitamin B12 supplementation mitigates B12 deficiency in this group.

scholarly journals Evaluation of Nutritional Deficiency-5 Years and More Outcomes Post Laparoscopic Sleeve Gastrectomy

2021 ◽  
Author(s):  
Elif Çırak ◽  
Seda Sancak ◽  
Ali Özdemir ◽  
Aziz Bora Karip ◽  
özgen çeler ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Vitamin B12 ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Serum Iron ◽  
Vitamin B12 Deficiency ◽  
Nutritional Deficiencies ◽  
B12 Deficiency ◽  
Compliance To Treatment ◽  
Treatment Of Obesity

Abstract IntroductionNowadays one of the most popular surgical method for treatment of obesity is laparoscopic sleeve gastrectomy (LSG). Data regarding long-term nutritional deficiencies following LSG are scare. We aim to assess the prevalence of nutritional deficiencies 5 years post-LSG.MethodsWe retrospectively reviewed the files of 338 patients who had LSG surgery between June 2012 and June 2019 and had preoperative data and had at least 1 year of surgery. Serum iron, ferritin, folic acid, hemoglobin and vitamin B12 levels during annual visits for six years after LSG were compared with preoperative data. Patients with missing data during follow-up were evaluated as dropout and assessments were made on patients with available data.ResultsA total of 338 patients (83% women), with a baseline BMI 46,87±6,17 kg/m2 were included. In baseline, hypoferritinemia was detected in 19.16% for <15 ng/mL cutoff and in 43.11% for <30 ng/ml cutoff value. Serum iron, vitamin B12 and folate deficiencies were exist in 37.62%, 18.64% and 4.14% of the patients, respectively. We compared this prevalances with postoperative datas and found that ferritin deficiency in follow-up visits was significantly more frequent than the baseline (p<0.001), conversely vitamin B12 deficiency was significantly less common (p<0,05).ConclusionDespite the supplement, our results show that the prevalence of patients with hypoferritinemia after LSG is higher than before surgery. This high prevalence may be associated with factors such as insufficient supplementation, insufficient absorption of oral preparations, and insufficient compliance to treatment.

scholarly journals Methylmalonic acid, vitamin B12, renal function, and risk of all-cause mortality in the general population: results from the prospective Lifelines-MINUTHE study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ineke J. Riphagen ◽  
Isidor Minović ◽  
Dion Groothof ◽  
Adrian Post ◽  
Manfred L. Eggersdorfer ◽  
...  
Keyword(s):  
Renal Function ◽  
Vitamin B12 ◽  
Methylmalonic Acid ◽  
Vitamin B12 Deficiency ◽  
Endogenous Production ◽  
Increased Risk ◽  
B12 Deficiency ◽  
Study Population ◽  
Age And Sex

Abstract Background Methylmalonic acid (MMA) is best known for its use as a functional marker of vitamin B12 deficiency. However, MMA concentrations not only depend on adequate vitamin B12 status, but also relate to renal function and endogenous production of propionic acid. Hence, we aimed to investigate to what extent variation in MMA levels is explained by vitamin B12 and eGFR and whether MMA levels are associated with mortality if vitamin B12 and eGFR are taken into account. Methods A total of 1533 individuals (aged 60–75 years, 50% male) were included from the Lifelines Cohort and Biobank Study. Individuals were included between 2006 and 2013, and the total follow-up time was 8.5 years. Results Median [IQR] age of the study population was 65 [62–69] years, 50% was male. At baseline, median MMA concentration was 170 [138–216] nmol/L, vitamin B12 290 [224–362] pmol/L, and eGFR 84 [74–91] mL/min/1.73 m2. Log2 vitamin B12, log2 eGFR, age, and sex were significantly associated with log2 MMA in multivariable linear regression analyses (model R2 = 0.22). After a total follow-up time of 8.5 years, 72 individuals had died. Log2 MMA levels were significantly associated with mortality (hazard ratio [HR] 1.67 [95% CI 1.25–2.22], P < 0.001). Moreover, we found a significant interaction between MMA and eGFR with respect to mortality (Pinteraction < 0.001). Conclusions Only 22% of variation in MMA levels was explained by vitamin B12, eGFR, age, and sex, indicating that a large part of variation in MMA levels is attributable to other factors (e.g., catabolism, dietary components, or gut microbial production). Higher MMA levels are associated with an increased risk for mortality, independent of vitamin B12, eGFR, and sex. This association was more pronounced in individuals with impaired renal function.

scholarly journals Ileocecal valve syndrome and vitamin b12 deficiency after surgery: a multicentric prospective study

2020 ◽  
Author(s):  
Paola Germani ◽  
Annalisa Zucca ◽  
Fabiola Giudici ◽  
Susanna Terranova ◽  
Marina Troian ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Ileocecal Valve ◽  
Female Gender ◽  
Right Colectomy ◽  
Bowel Habits ◽  
Intestinal Activity ◽  
B12 Deficiency ◽  
Eortc Qlq

AbstractPatients undergoing colon resection are often concerned about their functional outcomes after surgery. The primary aim of this prospective, multicentric study was to assess the intestinal activity and health-related quality-of-life (HRQL) after ileocecal valve removal. The secondary aim was to evaluate any vitamin B12 deficiency. The study included patients undergoing right colectomy, extended right colectomy and ileocecal resection for either neoplastic or benign disease. Selected items of GIQLI and EORTC QLQ-CR29 questionnaires were used to investigate intestinal activity and HRQL before and after surgery. Blood samples for vitamin B12 level were collected before and during the follow-up period. The empirical rule effect size (ERES) method was used to explain the clinical effect of statistical results. Linear mixed effect (LME) model for longitudinal data was applied to detect the most important parameters affecting the total score. A total of 158 patients were considered. Applying the ERES method, the analysis of both questionnaires showed clinically and statistically significant improvement of HRQL at the end of the follow-up period. Applying the LME model, worsening of HRQL was correlated with female gender and ileum length when using GIQLI questionnaire, and with female gender, open approach, and advanced cancer stage when using the EORTC QLQ-CR29 questionnaire. No significant deficiency in vitamin B12 levels was observed regardless of the length of surgical specimen. In our series, no deterioration of HRQL and no vitamin B12 deficiency were found during the follow-up period. Nevertheless, warning patients about potential changes in bowel habits is mandatory. In our series, no deterioration of HRQL and no vitamin B12 deficiency were found during the follow-up period. Nevertheless, warning patients about potential changes in bowel habits is mandatory.

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