Authors: van Loon, M.¹; Postels, D. G.²; Heikens, G. T.¹; Molyneux, E.¹

Source: Annals of Tropical Paediatrics: International Child Health, Volume 29, Number 3, September 2009 , pp. 231-234(4)

Publisher: Maney Publishing

Abstract:

An 8-year-old girl presented with severe muscular weakness, peripheral neuropathy, ataxia, fever and macrocytic anaemia. Clinically, vitamin B₁₂ (cobalamin) deficiency was considered. Despite the lack of pre-treatment laboratory confirmation of the diagnosis, a therapeutic trial of hydroxocobalamin injections was begun. After several days, a partial clinical response was seen. Within 5 months all symptoms had resolved. After treatment was initiated, laboratory analysis of pre-treatment blood samples confirmed the presence of vitamin B₁₂ deficiency. Auto-antibodies to intrinsic factor and parietal cells, pathognomonic for pernicious anaemia, were confirmed. Vitamin B₁₂ deficiency owing to dietary deficiency is not uncommon in children in developing countries. Although nutritional deficiency might have played a role in our patient, this case illustrates that the neurological manifestations of pernicious anaemia can present at a young age in African populations.

Document Type: Case Report

DOI: http://dx.doi.org/10.1179/027249309X12467994694094

Affiliations: 1: Department of Paediatrics & Child Health, College of Medicine, University of Malawi, Blantyre, Malawi 2: Presbyterian Medical Group, Albuquerque, New Mexico, USA

Publication date: 2009-09-01

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• In 2012 Annals of Tropical Paediatrics changed its name to Paediatrics and International Child Health to reflect changes and developments in the subject area. View the issues of Paediatrics and International Child Health available online.
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