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Selective Vitamin B 12 Malabsorption without Anaemia but with Profound Failure to Thrive
Author(s) -
AUCHTERLONIE I. A. A.,
THOM H.,
CAMPBELL A. G. M.
Publication year - 1985
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1985.tb11010.x
Subject(s) - malabsorption , medicine , failure to thrive , vitamin b12 , cyanocobalamin , macrocytosis , methylmalonic aciduria , vomiting , methylmalonic acid , endocrinology , gastroenterology
. A 7‐month‐old boy presented with vomiting and failure to thrive associated with proteinuria, methylmalonic aciduria and macrocytosis, but without anaemia. Plasma vitamin B12 levels were normal by a radio‐dilution method. He was treated as an inborn error of metabolism with intramuscular cyanocobalamin and a low protein diet. However when treatment was withdrawn he remained well for 11 months before relapsing with vomiting and weight loss. Re‐investigation again showed methylmalonic aciduria, but the haemoglobin was low and plasma vitamin B12 levels by a specific method showed them to be reduced. Studies of vitamin B12 absorption showed the picture of selective malabsorption. He was started on regular cyanocobalamin injections.