DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20182548

A prospective, cross sectional open label clinicoepidemiological study of vitamin B-12 deficiency in adolescent children

Chaturbhuj Singh, Pukhraj Garg, Rishi Sodawat

Abstract


Background: Megaloblastic anemia is becoming most common forms of anemia in adolescents during recent years. In India limited studies are available on megaloblastic anemia. The main aim of the study was to determine the incidence, prevalence, and various morphological patters and complications of vitamin B12 deficiency anemia in adolescents.

Methods: Hospital based cross sectional observational study of 100 adolescents anaemic patients (excluding anemia of bone marrow failure, haemolytic anemia associated with jaundice and organomegaly, aplastic anemia, leukaemia and anemia associated with chronic inflammatory disease) admitted in paediatric ward from 2016 to2017 was done. In every case detailed history, examination along with blood investigation done including complete blood count, blood indices and peripheral blood smear for morphology. In every case serum B12 level was estimated.

Results: Out of 100 cases 38% were deficient with female dominance. Significant association (p<0.05) was  found between B12 deficiency and  vegetarian diet, macrocytic peripheral film, pancytopenia, knuckle pigmentation and neurological symptoms.

Conclusions: Deficiency of B12 deficiency is common among the adolescents, which is common in vegetarian’s diet patterns. Supplementation through implemented nutritional programmes and education regarding diet patterns may overcome this deficiency.

 


Keywords


Anemia, Adolescents, B12

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References


Fenwick S. On atrophy of stomach and nervous affections of the digestive organ Lancet.1870;II:78-80.

Gardner W, Osler W. A case of progressive pernicious anemia. Med SurgJ.1877;5:385-404.

Leichtenstein O. Uber pernicious anemia. Deutsche Med Wochenschrift. 1884;10:849.

Minnich W. Lichtheim pernicious anemia. Medizin.1892;21:264-314

Russel JSR, Batten FE, Collier J. Subacute combined degeneration of spinal cord. Brain. 1900;23:39.

Minot GR, Murphy WP. Treatment of pernicious anemia by special diet. JAMA.1926;87:470-6.

Castle WB, Extinsic factor in pernicious anemia AMJ Med S. 1929;178:148.

Lassen HCA, Sahenk nitous oxide anesthesia. Lancet. 1956;1:527-30.

National Family and Health survey (NFHS-3), IIPS (2005-2006), Available at http://rchiips.org/nfhs/NFHS-3%20Data/VOL-1/India_volume_I_corrected_17oct08.pdf.

Chandra J, Jain V, Narain S, Sharma S, Singh V, Kapoor AK, et al. Folate and cobalamin deficiency in megaloblastic anemia in children. Indian Pediatr 2002;39:453-7.

Atay E, Akin ME, Ozhan B, Osman O, Karakus Y, Erdogan FI. Frequency of hematological findings associated with severe plasma vitamin B12 deficiency in infants and adolescents. Clin Lab. 2014;60(4):659-62.

Khanduri U, Sharma A, Joshi A. Occult Cobalamin and folate deficiency in Indians. Natal Med J India 2005;18:182-3.

Haq SS, Iqbal N, Fayyaz F, Tasneem T. Serum B12 and folate levels in patients with megaloblastic change in the bone marrow. Biomedica. 2012;28:35-9.

Rafik M, Zaid A, Muhammad M, Abdalla M, Maher H, Ibrahim A, et al. The impact of nutritional vitamin B12, folate and hemoglobin deficiency on school performance of elementary school children. J Pediatr Neur. 2008;6(3):243-8.

Villamor E, Mora-Plazas M, Forero Y, Lopez-Arana S, Baylin A. Socioeconomic and dietary correlates of vitamin Bl2 and folate status in school children from Bogota, Colombia. FASEB J 2007;21:674-8.

Nalli R, Adyar A, Anita S. Study of Etiology and Varied Clinical Features of Megaloblastic Anemia in Adolescents at Niloufer Hospital. IOSR-JDMS. 2016;15(1/5):16-20.

Patra S, Pemde HK, Singh V, Chandra J, and Dutta A. Profile of adolescents with severe anemia admitted in a tertiary care hospital in northern India. Indian J Pediatr. 2011;78(7):863-5.

Sanjeev M Chaudhary, Vasant R Dhage. A study of anemia among Adolescent females in the urban area of Nagpur. Indian J Community Med. 2008;33(4):243-5.

Sarode R, Garewal G, Marwaha N, Marwaha RK, Varma S, Ghosh K, et al. Pancytopenia in nutritional megaloblastic anemia: A study from north-west India. Trop Geog Med. 1989;41:331-6.

Black MM. Micronutrient Deficiencies and Cognitive Functioning. J Nutr. 2003;133(1l):3927S- 31.

Louwman MW, van Dusseldorp M, van de Vijver FJ, Thomas CM, Schneede J, Deland PM, et al. Signs of impaired cognitive function in adolescents with marginal cobalamin status. Am J Clin Nutr. 2000;72(3):762-9.

Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, Marcell PD, Stabler SP, Allen RH. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988;3(18):1720-8.

Savage DG, Lindenbaum J. Neurological complications of acquired cobalamin deficiency: clinical aspects. Baillieres Clin Haematol 1995;8:657-78.

Scalabrino G. Cobalamin (vitamin B12) in subacute combined degeneration and beyond: traditional interpretations and novel theories. Exp Neurol 2005;192:463-79.