Déficit de vitamina B12 en grupos vulnerables con alimentación omnívora

2021 ◽  
Vol 22 (3) ◽  
Author(s):  
Isabel Bianchi di Carcano ◽  
◽  
Marisa Armeno

Introduction: vitamin B12 plays an essential role in growth and neurodevelopment. Vitamin B12 deficiency is a public health problem in Argentina, with a high prevalence in a highrisk population, such as pregnant women and children with a vulnerable social situation, although their omnivorous diet. Objectives: to update the information available on vitamin B12 deficiency in vulnerable populations, in order to highlight the importance of the subject, to achieve an early diagnosis and timely treatment and thus prevent irreversible complications. Results: it is important that the pediatrician knows the different types of vitamin B12 deficiency presentation and to consider it as a differential diagnosis in children with neurological symptoms, even in the absence of anemia, to achieve early interventions and diminish the burden of disease. Many researchers have concluded that an isolated marker can lead to misdiagnoses, so it is currently recommended to use at least two. Most of the treatments evaluated, agree on the administration of 1 mg of B12, for 7 to 10 days, either intramuscular or orally, followed by 3 to 11 weeks of a weekly dose. Conclusions: it is important to update data on the prevalence of B12 deficiency in our country, as well as the implementation of therapeutic interventions and preventive public policies.

2008 ◽  
Vol 3 ◽  
pp. 204
Author(s):  
E.A. Merzon ◽  
P. Singer ◽  
R. Schneeweiss ◽  
T. Rips ◽  
E. Kitai

2017 ◽  
Vol 30 (10) ◽  
pp. 719
Author(s):  
Carlos Tavares Bello ◽  
Ricardo Miguel Capitão ◽  
João Sequeira Duarte ◽  
Jorge Azinheira ◽  
Carlos Vasconcelos

Introduction: Type 2 diabetes mellitus is a common disease, affecting up to 13.1% of the Portuguese population. In addition to the known micro and macrovascular complications, drug side effects constitute a major concern, leading to changes in the treatment guidelines, which favor safety over efficacy. Metformin is the first-line pharmacological treatment for most patients with type 2 diabetes mellitus; however, it has been associated with vitamin B12 deficiency in up to 30% of treated patients. The authors describe the prevalence of vitamin B12 deficiency in a diabetic population and explore the possible underlying factors.Material and Methods: Retrospective, observational study. Clinical and laboratory data of type 2 diabetes mellitus patients whose vitamin B12 status was evaluated in the last decade (2005 - 2016) were analyzed. Patients with known malabsorptive syndromes or having undergone bariatric surgery were excluded from the study. Statistical analysis of the data was done and the results were considered statistically significant at p values < 0.05.Results: The study included a total of 1007 patients (58% women) with a mean age of 66.4 ± 12.2 years and 11 ± 10.4 years of type 2 diabetes mellitus duration. These patients had a high prevalence of complications: diabetic renal disease 47.7%, neuropathy 9.2%, retinopathy 14.9%, coronary artery disease 8.4%, cerebrovascular disease 10.9%, and peripheral arterial disease 5.5%. Vitamin B12 deficiency (< 174 ng / dL) was present in 21.4% of the population and this subgroup was older (68.4 vs 65.8 years, p = 0.006), had a longer type 2 diabetes mellitus duration (13.35 vs 10.36 years; p = 0.001), higher prevalence of retinopathy (20.9% vs 13.3%; p = 0.005) and thyroid dysfunction (34% vs 23.7%; p = 0.002). Vitamin B12 deficiency was also more frequent in patients treated with metformin (24.7% vs 15.8%; p = 0.017), antiplatelet agents (25.4% vs 16.2%, p < 0.001), and calcium channel blockers (26.8% vs 18.2%; p = 0.001). After adjustment for possible confounders, the variables associated with B12 deficiency were: metformin, hypothyroidism, age and type 2 diabetes mellitus duration.Discussion: Despite the retrospective design, the results report a high prevalence of vitamin B12 deficiency in the type 2 diabetic population. This study also demonstrates that the B12 deficiency risk is higher in older people, with longer diabetes mellitus duration, hypothyroidism and treated with metformin.Conclusion: Further studies are needed to identify the risk factors for the B12 deficit. The recognition of these variables will contribute to optimize the screening and prevention of the B12 deficiency in type 2 diabetes mellitus.


2020 ◽  
Vol 41 (4) ◽  
pp. 430-437
Author(s):  
Bentu Kalyan G ◽  
Medha Mittal ◽  
Rahul Jain

Background: Vitamin B12 deficiency is prevalent worldwide especially in vegetarian communities. Its deficiency in early childhood may result in serious neurological and cognitive deficits. It is important to know the prevalence among our infants and toddlers so that nutritional policy changes could be suggested in this regard. Objective: To evaluate the vitamin B12 status of apparently healthy Indian children between 6 and 23 months of age. Methods: Apparently healthy Indian children (n = 210), of age 6 to 23 months, attending pediatric outpatient department were recruited and samples obtained to evaluate their hemogram and levels of vitamin B12, folate, and ferritin. Data were analyzed to obtain the mean levels and the proportion of participants deficient in vitamin B12. The dietary habits of the children were also analyzed and correlated with their vitamin B12 status. Results: Vitamin B12 deficiency was observed in 37.6% of the participants. Conclusions: There is a high prevalence of vitamin B12 deficiency in our infants and toddlers, and there is need to initiate supplement to prevent any possible neurological consequences. Early initiation of animal milk had a positive effect on the vitamin B12 status of the child, though it was not significant.


2017 ◽  
Vol 38 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Medha Mittal ◽  
Vijayashri Bansal ◽  
Rahul Jain ◽  
Pradeep Kumar Dabla

Background: Vitamin B12 deficiency in early life can adversely affect the growth of developing brain with myriad of neurodevelopmental manifestations. At this age, the deficiency is usually the result of low maternal levels. Objectives: To assess the vitamin B12 status of healthy exclusively breast-fed Indian infants aged 1 to 6 months and their mothers. Methods: One hundred term exclusively breast-fed infants aged 1 to 6 months attending pediatric outpatient department were recruited. Hemogram, serum B12, folate, and ferritin levels were obtained from each infant–mother pair. Results: The prevalence of B12 deficiency in infants was found to be 57%. Forty-six percent of mothers were deficient. There was a positive correlation ( r = .23) between the B12 levels of the infants and their mothers. Conclusion: There is a high prevalence of vitamin B12 deficiency in Indian infants and their mothers. There is an urgent need to supplement our population with vitamin B12, and the best time to do this would be antenatal.


Nutrients ◽  
2017 ◽  
Vol 9 (1) ◽  
pp. 72 ◽  
Author(s):  
Bernadette Ng’eno ◽  
Cria Perrine ◽  
Ralph Whitehead ◽  
Giri Subedi ◽  
Saba Mebrahtu ◽  
...  

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4812-4812
Author(s):  
Zoubida Tazi Mezalek ◽  
Wafaa Ammouri ◽  
Mouna Maamar ◽  
Meriem Bourkia ◽  
Hicham Harmouche ◽  
...  

Abstract Vitamin B12 deficiency should be suspected in all patients with unexplained anemia and/or neuropsychiatric symptoms, and special attention should be paid to patients at risk (the elderly, vegetarians, patients with autoimmune thyroiditis or vitiligo, patients receiving proton pump inhibitors or biguanides for prolonged periods). Documented symptomatic pancytopenia related to cobalamin deficiency is very rare representing less than 5% cases in different series. We aim to report an important series of pancytopenia related to cobalamin deficiency to analyze the clinical, biological and outcomes of those patients. Methods : Consecutive patients presented with B12 deficiency and pancytopenia were included. Charts were retrospectively reviewed from an internal medicine department during a period of 15 years (2000-2015). Diagnosis of cobalamine deficiency used the vitamin B12 dosage bellow 200 pg/ml. Assessment included clinical features, blood count and morphological review and a statistical analysis of those parameters comparing pancytopenic and non-pancytopenic patients. Results The medical records of 268 consecutive patients hospitalized for cobalamin deficiency from January 2000 to December 2015 were identified and retrospectively analyzed. Among them, 104 patients had pancytopenia (38.8%). The median age was 55+17 years and the sex ratio : 1. Pancytopenia revealed vitamin B12 deficiency in all cases. Neurological manifestations were associated in 13 cases and digestive involvement in 16 cases. Twenty five patients presented with febrile neutropenia. Fourteen patients (13.4%) presented with "pseudo" thrombotic microangiopathy. The mean hemoglobin level was 58+19 g/L, the neurtophils count was 1188+579/µl and median platelets count was 69.616+34.379/µl. Macrocytosis was present in 80.7% of patient with mean MCV was 106+11 fl, but was normal (<95 fl) in 20 patients. The mean serum vitamine B12 levels was 80+11 pg/ml. The median serum lactate dehydrogenase level was high (3.204 IU/L). The causes of B12 vitamin deficiency were mainly food cobalamin malabsorption (63.4%) and pernicious anemia (28.8%). Correction of the hematological abnormalities was achieved in all patients treated with either intramuscular, subcutaneous or oral cyanocobalamin. Significant differences appears comparing patients with or without pancytopenia. Pancytopenic patients had significantly lower MCV mean (p=0.001), lower polynuclear neutrophils count and lower platelets count. Atrophic gastritis was also significantly associated with pancytopenia (p=0.005). There was no significant difference in mean haemoglobin level (p=0.3), serum cobalamin level (p=0.17). Looking at other variables that could explain the high prevalence of pancytopenia in our series, there were no difference in ferritinemia level or number of patients with of iron deficiency . Conclusion In this study, based a single institution with a large number of consecutive patients with well-documented cobalamin deficiency, we found a high prevalence (38,8%) of severe pancytopenia. We don't find yet an explanation for those findings. Those results can also remind us that severe vitamin B12 deficiency may present with findings mimicking malign hematologic disorder and timely recognition and supplementation lead to resolution of symptoms and blood abnormalities. Disclosures No relevant conflicts of interest to declare.


2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Setareh Shahab‐Ferdows ◽  
Reina Engle‐Stone ◽  
Daniela Hampel ◽  
Alex Ndjebayi ◽  
Martin Nankap ◽  
...  

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