Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children26310.24287/1726-1708-2019-18-3-70-77CLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯVitamin B12-deficiency anemia in infants: clinical presentation, current diagnostic and treatmentВитамин В12-дефицитная анемия у детей грудного возраста: клиническая картина, современные методы диагностики и леченияhttps://orcid.org/0000-0002-4543-2945LunyakovaM. A.ЛуняковаМ. А.
Russian Federation

Reserch center for hematology, oncology and immunology

Ryazan

Рязань

https://orcid.org/0000-0002-6120-4678DemikhovV. G.ДемиховВ. Г.
Russian Federation

Valery Grigorievich Demikhov, MD. Head of Reserch center for hematology, oncology and immunology

390029, Ryazan Stroiteley st; 5-в

Демихов Валерий Григорьевич, доктор медицинских наук, профессор, директор научно-клинического центра гематологии, онкологии и иммунологии

390029, Рязань, ул. Строителей, 5-в

demix777@ya.ruhttps://orcid.org/0000-0001-7691-0316DronovaS. N.ДроноваС. Н.
Russian Federation

Ryazan

Рязань

https://orcid.org/0000-0002-7280-7212KalininaYu. Yu.КалининаЮ. Ю.
Russian Federation

Ryazan

Рязань

https://orcid.org/0000-0002-2159-582XZhurinaO. N.ЖуринаО. Н.
Russian Federation

Reserch center for hematology, oncology and immunology

Ryazan

Рязань

Ryazan state medical university named after academician I.P. PavlovНаучно-клинический центр гематологии, онкологии и иммунологии ФГБ ОУ ВО «Рязанский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииRyazan state medical university named after academician I.P. PavlovФГБ ОУ ВО «Рязанский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииN. Dmitrieva Ryazan Regional Clinical Children's HospitalГБУ Рязанской области «Областная детская клиническая больница им. Н.В. Дмитриевой»Ryazan City Clinical Hospital № 11ГБУ Рязанской области «Городская клиническая больница № 11»1309201918370771309201913092019Copyright ©; 2019, «D. Rogachev NMRCPHOI»Copyright ©; 2019, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2019«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/263

Vitamin B12 (cobalamin) deficiency in infants exclusively breastfed is usually the result of its deficiency in the mothers (vegetarians or in the presence of unrecognized pernicious anemia or malabsorption syndrome). Cobalamin is crucial for the normal development of the nervous system, the production of erythrocytes and the synthesis of DNA. The classic manifestation of its deficiency is megaloblastic anemia and, in advanced cases, pancytopenia. However, infants often present neurological symptoms (fatigue, failure to thrive, regress of developmental skills, lethargy, motor disorders), as a consequence of inadequate myelination of the brain. Cobalamin treatment is effective in the most children, however, the neurological deficit varying degrees may persist. The long-term prognosis depends on overall duration of vitamin B12 deficiency and severity of symptoms. The article presents our own interesting clinical observations. Parents gave their permission for using personal data for clinical research and publications.

Дефицит витамина В12 (кобаламина) у детей, находящихся исключительно на грудном вскармливании, – обычно результат его дефицита у матерей (вегетарианки, с нераспознанной пернициозной анемией или синдромом мальабсорбции). Кобаламин имеет решающее значение для нормального развития нервной системы, производства эритроцитов и синтеза ДНК. Классическое проявление его дефицита – мегалобластная анемия, в продвинутых ее стадиях – панцитопения. Однако у маленьких детей превалирует неврологическая симптоматика (регресс навыков развития, летаргия, двигательные расстройства) как следствие неадекватной миелинизации головного мозга. На фоне терапии кобаламином у большинства детей неврологическая симптоматика регрессирует, однако может сохраняться неврологический дефицит разной выраженности. Долгосрочный прогноз зависит от длительности дефицита витамина В12. В статье приведены собственные интересные клинические наблюдения. Родители пациентов дали согласие на использование информации о ребенке в научных исследованиях и публикациях.

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