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Maternal vegan diet causing a serious infantile neurological disorder due to vitamin B12 deficiency

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Abstract

We present a 9-month-old exclusively breastfed baby of a strict vegetarian mother who had excluded all animal proteins from her diet. The patient's symptoms included dystrophy, weakness, muscular atrophy, loss of tendon reflexes, psychomotor regression and haematological abnormalities. Biochemical investigations revealed severe methylmalonic aciduria and homocystinuria in the patient, slight methylmalonic aciduria in the mother and low concentrations of serum vitamin B12 in both patient and mother.

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Abbreviations

LDH:

lactic dehydrogenase

MMA:

methylmalonic acid

References

  1. Baker S, Jacob E, Rajan K, Swaminathan S (1962) Vitamin B12 deficiency in pregnancy and the puerperium. Br Med J 1: 1658–1661

    Google Scholar 

  2. Baumgartner RE, Wick H, Maurer R, Egli N, Steinmann B (1979) Congenital defect in intracellular cobalamin metabolism resulting in homocystinuria and methylmalonic aciduria. I. Case report and histopathology. Helv Paediatr Acta 34: 465–482

    PubMed  Google Scholar 

  3. Baumgartner RE, Wick H, Linnell JC, Gaull GE, Bachmann C, Steinmann B (1979) Congenital defect in intracellular cobalamin metabolism resulting in homocystinuria and methylmalonic aciduria. II. Biochemical investigations. Helv Paediatr Acta 34:483–496

    PubMed  Google Scholar 

  4. Chanarin I (1985) Folate and cobalamin. Clin Haematol 14: 629–641

    PubMed  Google Scholar 

  5. Doyle JJ, Langevin AM, Zipursky A (1989) Nutritional vitamin B12 deficiency in infancy: three case reports and a review of the literature. Pediatr Hematol Oncol 6:161–172

    PubMed  Google Scholar 

  6. Ellenbogen L (1984) Vitamin B12. In: Machlin LJ (ed) Handbook of vitamins. Nutritional, biochemical, and clinical aspects. Dekker, New York, pp 497–547

    Google Scholar 

  7. Fenton WA, Rosenberg LE (1989) Inherited disorders of cobalamin transport and metabolism. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic basis of inherited disease, 6th edn. McGraw-Hill, New York, pp 2065–2082

    Google Scholar 

  8. Food and nutrition board (1980) Recommended dietary allowances, 9th edn. National Academy of Sciences, Washington

    Google Scholar 

  9. Gambon RC, Lentze MJ, Rossi E (1986) Megaloblastic anaemia in one of monozygous twins breast fed by their vegetarian mother. Eur J Pediatr 145:570–571

    PubMed  Google Scholar 

  10. Herbert V (1988) Vitamin B-12: plant sources, requirements, and assay. Am J Clin Nutr 48:852–858

    PubMed  Google Scholar 

  11. Higgingbottom MC, Sweetman L, Nyhan W (1978) A syndrome of methylmalonic aciduria, homocystinuria, megaloblastic anemia and neurologic abnormalities in a Vit B12 deficient breast-fed infant of strict vegetarian. N Engl J Med 299: 317–323

    PubMed  Google Scholar 

  12. Lampkin B, Saunders EF (1969) Nutritional vitamin B12 deficiency in an infant. J Pediatr 75:1053–1055

    PubMed  Google Scholar 

  13. Ramsey RB, Scott T, Banik NL (1977) Fatty acid composition of myelin isolated from the brain of a patient with cellular deficiency of co-enzyme forms of vitamin B12. J Neurol Sci 34: 221–232

    PubMed  Google Scholar 

  14. Scott JM, Weir DG (1981) The methyl folate trap. Lancet II:337–340

    Google Scholar 

  15. Stabler SP, Marcell PD, Podell ER, Allen RH, Lindenbaum J (1986) Assay of methylmalonic acid in the serum of patients with cobalamin deficiency using capillary gas chromatographymass spectrometry. J Clin Invest 77:1606–1612

    PubMed  Google Scholar 

  16. Stabler SP, Marcell PD, Podell ER, Allen RH, Savage DG, Lindenbaum J (1988) Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by cpaillary gas chromatography-mass spectrometry. J Clin Invest 81:466–474

    PubMed  Google Scholar 

  17. Stollhoff K, Schulte FJ (1987) Vitamin B12 and brain development. Eur J Pediatr 146:201–205

    PubMed  Google Scholar 

  18. Wighton MC, Manson JI, Speed I, Robertson E, Chapman E (1979) Brain damage in infancy and dietary vitamin B12 deficiency. Med J Aust 2:1–3

    Google Scholar 

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Kühne, T., Bubl, R. & Baumgartner, R. Maternal vegan diet causing a serious infantile neurological disorder due to vitamin B12 deficiency. Eur J Pediatr 150, 205–208 (1991). https://doi.org/10.1007/BF01963568

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  • DOI: https://doi.org/10.1007/BF01963568

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