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A Preventable Cause of Hypotonia in Infants: Case Report of Two Infants with Vitamin B12 Deficiency

Akhrif M^1*, Saghir S², Kmari M², Ourrai A², Hassani A², Abilkassem R², Agadr A^2
1Department of Pediatrics, Rabat Children's Hospital, Rabat, Morocco
²Department of Pediatrics, Mohamed V Military Training Hospital, Rabat, Morocco

Corresponding Author: Akhrif M ^{ORCID iD}
Address: Department of Pediatrics, Rabat Children's Hospital, Rabat, Morocco.
Received date: 02 July 2021; Accepted date: 05 August 2021; Published date: 12 August 2021

Citation: Akhrif M, Saghir S, Kmari M, Ourrai A, Hassani A, Abilkassem R, Agadr A. A Preventable Cause of Hypotonia in Infants: Case Report of Two Infants with Vitamin B12 Deficiency. Asp J Pediatrics Child Health. 2021 Aug 12;3(2):48-51.

Copyright © 2021 Akhrif M, Saghir S, Kmari M, Ourrai A, Hassani A, Abilkassem R, Agadr A. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: Cerebral Atrophy, Developmental Regression, Hypotonic Infant, Vitamin B12 Deficiency

Abstract

Introduction: Innate deficits in the metabolism or transport of vitamin B12 are exceptional. The main cause of vitamin B12 deficiency in infants is secondary to maternal deficiency. Maternal deficiency can have a vegan diet, low socio-economic level (developing countries) and a high level of development with a poor diet) or digestive pathologies responsible for a lack of absorption. The clinical signs are not very specific (developmental delay, pallor, hypotonia, vomiting and diarrhoea), which explains the frequent delay in diagnosis. The pathophysiology of the neurological damage, which is still uncertain, is thought to be secondary to a defect in myelination with altered nerve conduction and cortical atrophy. The aim of this work is to underline the importance of raising awareness of vitamin B12 deficiency in order to avoid its profound neurological repercussions, especially as substitution treatment allows an improvement or a reversibility of the neurological damage and raises the question of the possibility of screening new-borns.
Materials and Methods: We report the case of two infants aged 6 months and 10 months with hypotonia and psychomotor regression from an early age, whose biological examination revealed pancytopenia with a collapsed vitamin B12 level in both infants and both mothers.