Coma and respiratory failure in a child with severe vitamin B12 deficiency

Daniela Codazzi, Francesca Sala, Rossella Parini, Martin Langer

Research output: Contribution to journalArticlepeer-review


Objective: Psychofunctional follow-up of severe vitamin B12 deficit. Design: Case report. Setting: Pediatric intensive care unit. Patient: Ten-month-old boy. Intervention: Follow-up at 3 yrs. Measurements and Main Results: A 10-month-old boy was admitted to the pediatric intensive care unit with respiratory failure, muscular hypotonia, and involuntary movements. Although a central nervous system infection was excluded, computed tomography scan showed a diffuse cortical-subcortical atrophy. Vitamin B12 deficiency was suspected because of a red-cell count of 1,350,000/mm3 and a hemoglobin value 5.9 g/dL (MCV 116). The baby had been exclusively breast-fed, but his mother had been a strict vegan for 10 yrs. Chronic dietary vitamin B12 deprivation was confirmed by blood and urinary samples. Treatment with vitamin B12 led in 2 wks to rapid and complete hematological improvement and to partial regression of neurologic symptoms. During the following 3 yrs the boy had normal vitamin intake and underwent intensive rehabilitative treatment. The brain atrophy regressed, but linguistic and psychomotor delay persisted. Conclusions: Rapid clinical improvement after vitamin supply does not correlate with a complete recovery.

Original languageEnglish
Pages (from-to)483-485
Number of pages3
JournalPediatric Critical Care Medicine
Issue number4
Publication statusPublished - Jul 2005

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine


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