CASE SERIES OF MEGALOBLASTIC ANEMIA DUE TO VITAMIN 12 DEFICIENCY IN A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 31-33
Author(s):  
Seema Soni ◽  
Sandhya Haribhakta ◽  
Deepali Ambike ◽  
Vineet Rathod
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Case Series ◽  
Severe Anaemia ◽  
Interesting Case ◽  
Neurological Involvement ◽  
Age Group ◽  
Low Socioeconomic ◽  
Socioeconomic Strata

We report herein an interesting case series of pediatric patients presenting with vitamin B12 deciency. It includes eight th patients admitted with us from 15 November 2020 to 15th January 2021.Our patients can be classied into less than or equal to 2 years age group and those more than or equal to 10 years age group, for having different clinical presentation. Out of the 8 patients,5 were females and 3 were males. In a span of less than 2months (post covid situation with economic crisis), these patients from low socioeconomic strata presented in emergency department with severe anaemia with or without neurological involvement. All patients were either exclusively breast fed or vegetarians. Vitamin B12 deciency may lead to serious neurological decits in addition to megaloblastic anaemia. Persistent neurological damage can be prevented with early diagnosis and treatment. We believe that a thorough clinical and neurological assessment might prevent failure to notice rare but possible vitamin B12 deciency in infants with neurological decits and neurodevelopmental retardation.

scholarly journals Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series

2018 ◽  
Vol 45 (6) ◽  
pp. 669-674 ◽  
Author(s):  
Ajay Mishra ◽  
Aditya Binu ◽  
George Abraham ◽  
Harshad Vanjare ◽  
Tina George ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Neurological Complications ◽  
Neurological Deficits ◽  
Neurological Involvement ◽  
Scorpion Sting ◽  
Male Predominance ◽  
Cerebrovascular Injury ◽  
Snake Envenomation

AbstractBackgroundNeurological complications following snake and scorpion bite are diverse. Literature regarding patterns of cerebrovascular injury (CVI) and outcomes among these patients is scarce. This is a descriptive study of the clinical profile, brain imaging findings, mechanisms of injury, vascular territory involvement and outcomes of CVI following scorpion and snake envenomation, in a tertiary care center in South India.MethodologyPatients with scorpion sting- and snake envenomation-related complications were retrospectively enrolled. Neuroimaging was performed on five patients with each envenomation, and they were found to have neurological involvement. On imaging, three patients were found to have a CVI. Clinical, radiological parameters and outcomes of these patients were studied. We also performed a review of the literature and analyzed the finding of all the cases.ResultIn all, three patients each had evidence of CVI in imaging. An additional 32 reports of scorpion sting-related CVI and 35 reports of snake envenomation-related CVI were identified from the literature. There was a male predominance among these patients. Mean age of the patients with scorpion sting was 42.8 years as compared with 33 years for the patients with snake envenomation. Features of severe envenomation were present in all patients. Persistently depressed sensorium and new-onset focal neurological deficits were seen in 70% of all patients. Infarcts were seen in 88% of patients with snake envenomation and 53% of patients with a scorpion sting. Mortality was 28% among patients with a scorpion sting as compared with 8% with snake envenomation.ConclusionCerebrovascular injuries are uncommon neurological manifestations following scorpion and snake envenomation. These tend to occur in younger patients. Infarcts are more common than bleeds.

scholarly journals Homocystinuria masquerading as vitamin B12 deficiency

2012 ◽  
Vol 4 (2) ◽  
pp. 326-328
Author(s):  
M Wadhwani ◽  
S Beri ◽  
A Saili ◽  
S Garg
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Interesting Case ◽  
Vitamin B ◽  
Ophthalmological Examination ◽  
Ophthalmic Manifestations ◽  
History Of ◽  
B12 Deficiency ◽  
Vitamin B 12

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

scholarly journals A clinical and demographic profile of the cleft lip and palate in Sub-Himalayan India: A hospital-based study

2012 ◽  
Vol 45 (01) ◽  
pp. 115-120 ◽  
Author(s):  
Jyoti Dvivedi ◽  
Sanjay Dvivedi
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Health Workers ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Low Socioeconomic ◽  
The Status ◽  
Baseline Information ◽  
History Of

ABSTRACT Objectives: To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region. Design: A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years. Outcome measures: The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment. Results: Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results. Conclusion: This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.

Reversible Hyperpigmentation: A Diagnostic Dilemma

2021 ◽  
Vol 12 (6) ◽  
pp. 113-115
Author(s):  
Somnath Maitra ◽  
Kaushik Hazra ◽  
Biswaroop Mukherjee
Keyword(s):  
Blood Transfusion ◽  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
Skin Lesions ◽  
Interesting Case ◽  
Diagnostic Dilemma ◽  
Prompt Treatment ◽  
B12 Deficiency

Vitamin B12 deficiency presents as megaloblastic anemia with neurological, skin and other clinical manifestations. We present here an interesting case of anemia presenting with generalized weakness and nonspecific symptoms in a female who is a vegetarian. There was acral hyperpigmentation without any other clinical features, Investigations revealed megaloblastic anemia with low vitamin B12 and normal RBC folate levels. The patient improved after blood transfusion and intramuscular vitamin B12 injections and the skin lesions faded away suggesting vitamin B12 deficiency to be the cause of hyperpigmentation, which is an uncommon manifestation. The importance lies in the fact that this cause of reversible hyperpigmentation should be thought of by clinicians to start prompt treatment.

scholarly journals Serum vitamin B12 levels in severe acute malnutrition hospitalized children between age group 6 months to 59 months in Kangra, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1997
Author(s):  
Ajay Vaid ◽  
Milap Sharma ◽  
Jamunashree B. ◽  
Piyush Gautam
Keyword(s):  
Vitamin B12 ◽  
Severe Acute Malnutrition ◽  
Megaloblastic Anemia ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Work Capacity ◽  
Acute Malnutrition ◽  
Age Group ◽  
Female Ratio ◽  
Increased Risk

Background: Child malnutrition is a major global health problem contributing to childhood morbidity, mortality, impaired intellectual development, suboptimal adult work capacity and increased risk of diseases in adulthood. Severe acute malnutrition, among children below five years of age remains a major embarrassment, and impediment to optimal human capital development in India.Methods: The study was an observational study conducted in the Department of Pediatrics and Biochemistry at Dr. RPGMC Kangra at Tanda, Himachal Pradesh. All children aged between 6 to 59 months presenting in the Department of Pediatrics with SAM (Severe Acute Malnutrition) and fulfilling the inclusion and exclusion criteria were included in the study after taking the informed consent from the guardian in local language.Results: Out of 48 children included in the study, 28 (58%) children were Males and 20 (42%) children were females with male to female Ratio 1.3:1. Out of 48 children 28 (58%) were vitamin B12 deficient and 20 (42%) were non-deficient. In the present study 53.5% (15) of males were vitamin B12 deficient. Out of 20 females 65% (13) of females were vitamin B12 deficient, showed slight preponderance of females over males. It has been observed that younger age group children mostly <2-year-old were, the most vulnerable group as far as vitamin B12 deficiency is considered (16%)Conclusions: Micronutrients play a central part in metabolism and in maintenance of tissue functions. All severely malnourished children have vitamin and mineral deficiencies. The most common type of anemia was microcytic followed by megaloblastic anemia.

scholarly journals KNUCKLE HYPERPIGMENTATION AS A PRELIMINARY MARKER OF VITAMIN B 12 DEFICIENCY: A CASE SERIES

2021 ◽  
pp. 36-38
Author(s):  
Manali Patil ◽  
S. N. Agrawal ◽  
V. V. Saoji
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Case Series ◽  
Vitamin B12 Deficiency ◽  
Neurological Deficits ◽  
Vitamin B ◽  
Important Clue ◽  
B12 Deficiency ◽  
Systemic Manifestations ◽  
Vitamin B 12

Vitamin B12 deficiency is common in vegetarian population in India and can present with variable Hematological (megaloblastic anemia), Neuropsychiatric, Mucocutaneous (glossitis, angular stomatitis), Skin (pallor, hyperpigmentation) and Hair changes (dry, brittle, thin, lustreless, prematurely grey). Knuckle hyperpigmentation has been described in vitamin B12 deficiency but usually these patients are dermatologically asymptomatic but they have systemic manifestations like megaloblastic anemia, pancytopenia or neurological deficits. The foreground of this study is highlighting the importance of knuckle hyperpigmentation as an early cutaneous sign of vitamin B12 deficiency which points an important clue towards the aetiology of Megaloblastic anemia.

scholarly journals MEGALOBLASTIC PANCYTOPENIA MIMICKING HELLP SYNDROME IN LATE PREGNANCY: A CASE REPORT

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Siddharth Sharma ◽  
Kunal Das ◽  
Mansi Kala ◽  
Sushil Kumar Shukla ◽  
Ruchira Nautiyal ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Hellp Syndrome ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Late Pregnancy ◽  
Severe Form ◽  
Interesting Case ◽  
Termination Of Pregnancy ◽  
B12 Deficiency ◽  
Keywords Hellp Syndrome

Introduction: Hemolysis, Elevated liver enzyme, low platelet (HELLP) syndrome is often noted as a complication of preeclampsia but can occur without this association as well. Severe form often requires termination of pregnancy. Vitamin B12 deficiency is common in vegetarian population and can mimic HELLP syndrome. Case Summary: We present an interesting case which was initially thought to be HELLP syndrome based on the clinical presentation and patient was planned for induction of labour,  but later on it was found out to be a case of Vitamin B12 deficiency on the basis of Lab findings. Patient responded well to the B12 supplementation and unjustified termination of pregnancy was avoided. Conclusion: This case illustrates an interesting clinical misdiagnosis of HELLP syndrome in an overt megaloblastic anemia. An elaborated workup with clinical suspicion should be made for megaloblastic anemia in such condition. Keywords: HELLP syndrome, Megaloblastic Anemia, Vitamin B12 deficiency, Pregnancy

scholarly journals Clinicohematological profile of pancytopenia: a study from a tertiary care hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 478
Author(s):  
Rakesh Kumar Yadav ◽  
Sujit Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Clinical Feature ◽  
Study Group ◽  
Care Hospital ◽  
Female Ratio ◽  
B12 Deficiency

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF CHILDREN WITH MEGALOBLASTIC ANEMIA AT A TERTIARY CARE HOSPITAL IN WESTERN INDIA: A CROSS SECTIONAL STUDY

2021 ◽  
pp. 35-38
Author(s):  
Anjali Sharma ◽  
Anand Deshpande ◽  
Chhavi Sauparna ◽  
Zeeshan Ahmed
Keyword(s):  
Bone Marrow ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Neurological Manifestation ◽  
Vitamin B ◽  
Western India ◽  
Care Hospital ◽  
Vitamin B 12

Background: In India most cases of Megaloblastic anemia are caused by nutritional deciency of vitamin B12 and Folic acid. Initial workup include Complete Blood Count(CBC), Peripheral blood smear(PBS) ,Vitamin B12 asssay, folic acid assay and Bone marrow if required. Therefore, this study is planned to study the clinical and laboratory prole of children with Megaloblastic anemia and to study the clinical outcome of children with Megaloblastic anemia Methods: The study was a prospective observational study conducted among 60 children with megaloblastic anemia, aged 1- 12 years. Demographic data, clinical symptoms and signs, laboratory ndings, serum B12 and Folic acid ,Bone marrow report and stool routine microscopy report were collected. Chi square test was applied. Results: Among the 60 children 40% were female sand 60% were males. The age of the study population ranged from a minimum of 1 month to a maximum of 12 years with a mean(SD) of 8.08 (± 5.45).Majority of children (41.6%) were in age group of 6 months- 1 year. Most common symptoms fever and most common sign is pallor. More than fty percent cases presented with severe anemia. Many cases reported late, leading to delay in diagnosis leads to poor outcome. Developmental delay (neurological manifestation) is strongly associated with vitamin B 12 deciency as compared to folic acid deciency. (p value <0.05) Conclusions: There is a slight female preponderance seen in megaloblastic anemia, probably due to reduced attention to girl children in the study group. neurological manifestation is strongly associated with vitamin B 12 deciency as compared to folic acid deciency.

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