Vitamin B12 Deficiency and a Patient Case Study
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Case study vitamin b12. Case Study: A Baby with Severe Vitamin B12 Deficiency | Viapath

Of note, all blood work was performed prior to commencing any medical treatment or blood transfusions.

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However, gcse media studies coursework grade boundaries low reticulocyte count at admission points to intramedullary haemolysis due to cobalamin deficiency rather than haemolysis due to an infection.

Outcome and follow-up The patient reported an increased level of well-being, including a good appetite, only a few days following therapy. Her plummeting iron levels and lack of diagnosis meant she was readmitted to hospital for a capsule endoscopy.

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No blastic cells were seen. In the physical examination, the patient looked pale and weak, and his sclerae were icteric.

Case Study: A Baby with Severe Vitamin B12 Deficiency

Hence, vitamin B12 deficiency results in the accumulation of homocysteine and methylmalonic acid. Our patient had severe macrocytic anaemia, pancytopenia and findings of haemolysis fragmented, misshapen cells in the peripheral smear mimicking microangiopathic haemolytic anaemia, indirect hyperbilirubinaemia and marked increase in LDH.

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However, appropriate therapy can lead to complete recovery in up to two-thirds of patients treated [ 23 ]. Directors duties essay law teacher is essential for DNA synthesis and haematopoiesis, and its severe deficiency not only causes megaloblastic anaemia, but may also result in thrombocytopaenia and leucopenia neutropeniaas in our patient.

Vitamin B12 Deficiency and a Patient Case Study

Transient, self-limited neurological exacerbations may sometimes occur during the first few weeks of treatment. The presence of anemia also carries important prognostic significance.

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As our patient had been on a vegetarian diet for years, and anti-IF and antiparietal cell antibodies were found negative, no endoscopic examination was performed.

Computed tomography of the head revealed mild cerebral atrophy. Accordingly, enzymatic defects resulting from vitamin B12 deficiency lead to accumulation of methylmalonic acid and homocysteine, which appear to be proportionally related to the severity of the associated neurological and psychiatric abnormalities [ 4 ].

Vitamin B12 Deficiency - USMLE Biochemistry Case based discussion

Laboratory findings performed at that time were all normal haemoglobin Concurrent haemolysis in patients with vitamin B12 deficiency is a well-recognised phenomenon and has been attributed mainly apa style curriculum vitae sample intramedullary destruction of erythrocytes ineffective erythropoiesis. Introduction Vitamin B12 is essential for normal blood synthesis and neurological function.

 CTscan of the liver and pelvis with IV

Chest radiography and computed tomography of the abdomen and pelvis were unremarkable. Abstract A year-old boy on a vegetarian diet presented with severe macrocytic anaemia haemoglobin, 5.

Cite this article: Rusher DR, Pawlak R () A Review of 89 Published Case Studies of Vitamin B12 Deficiency. J Hum Nutr Food Sci 1(2). Case Study: A Baby with Severe Vitamin B12 Deficiency. Wednesday, 26 October, A nine month old girl was admitted to the Metabolic Unit at Evelina.

Vitamin Case study vitamin b12 deficiency may present with findings mimicking acute leukaemia ie, pancytopenia and organomegaly. His collateral history obtained from family members confirmed a significant behavioral change over the past year, during which they observed irritability and emotional lability, as well as difficulty with self-care, grooming and personal hygiene.

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  • His neuropsychiatric symptoms and cognition had also improved significantly by the time of hospital discharge.
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  • Case Study: A Baby with Severe Vitamin B12 Deficiency | Viapath
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We describe an unusual case of a patient with severe vitamin B12 apa style curriculum vitae sample together with profound hematological derangements and florid neuropsychiatric impairment. Ellen read about iron deficiency anaemia in 'Could It Be B12?

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The patient denied smoking, alcohol consumption or illicit drug use. During a review of systems, he denied any sensory deficits, visual impairment or taste perversion, and he also denied any history of bleeding, bruising or recent infection.

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  • Concurrent haemolysis in patients with vitamin B12 deficiency is a well-recognised phenomenon and has been attributed mainly to intramedullary destruction of erythrocytes ineffective erythropoiesis.
  • He was irritable, paranoid, delusional and highly circumstantial and had grandiose thoughts and impaired insight.

He had no significant family history of any illness. The most common cause of cobalamin deficiency in infants and children is inadequate consumption due to dietary restriction or lack of access to animal-sourced food.

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Of note, he did not have evidence of splenomegaly, oral ulcers, nail changes or vitiligo. She was subjected to multiple investigative procedures and was hospitalised for months - emerging without any concrete diagnosis. He denied any hallucinations. As such, the coexistence of significant anemia and neurological deficits is thought to be rare.


He was irritable, paranoid, delusional and highly circumstantial and had grandiose thoughts and impaired insight. Paleness and icterus in the sclerae had been noted by the parents for about 2 years, although these findings became more obvious within the last few weeks.

He introduce my friend essay high-functioning before the onset of his present illness. Classically, vitamin B12 deficiency may give rise to megaloblastic anemia and sub-acute combined degeneration of the spinal cord with demyelination of the dorsal column, resulting in both motor and sensory deficits.

Reticulocytosis was not assessed due to the unavailability of testing at the time.

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Differential diagnosis In the differential diagnosis, haemolytic anaemia of any cause ie, G6PD deficiency, autoimmune haemolytic anaemia, haemolytic uraemic syndrome, hereditary spherocytosishaematological malignancy, infectious causes, aplastic anaemia, storage disorders and haemophagocytic lymphohistiocytosis due to pancytopenia and splenomegalyvitamin B12 or folic acid deficiency due to macrocytic anaemia and autoimmune lymphoproliferative syndrome due to the combined finding of haemolysis, pancytopenia and splenomegaly were considered.

He was not taking any medications at the time of presentation.

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Haematological findings resolved completely following appropriate replacement therapy. Because of the profound symptomatic anemia at presentation, the patient was initially given a transfusion of 2U of thesis statement about greece red blood cells upon admission.

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ECG and echocardiographic examinations were normal. Anemia detected at baseline is inversely related to the severity of neurological impairment at diagnosis.

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Antiendomysial and anti-tissue transglutaminase IgA antibodies for screening celiac sprue, and anti-intrinsic factor anti-IF and antiparietal cell antibodies for pernicious anaemia were all negative. Other causes of pancytopenia which may be characterized by a hypoproliferative, megaloblastic, macrocytic anemia—such as folate deficiency, hypothyroidism, viral illness and exposure to potential offending medications—were ruled out.

Among patients with neurological disease, anemia and macrocytosis are the most common hematological derangements detected, and, when they are argumentative essay for death penalty, anemia and macrocytosis are typically minor and subtle [ 46 ].

We present this case as a reminder that severe vitamin B12 deficiency may Bone marrow aspiration study demonstrated macromegaloblastic. J R Soc Health. Oct;(5) Lessons to be learned: a case study approach. Vitamin B12 deficiency of nutritional origin. Donaldson D(1).

Appropriate treatment results in rapid resolution of associated symptoms and of abnormal laboratory findings.