Volumen: 20 # Number : 3
Publication Date : Septiembre - Diciembre Year: 2016
Pancytopenia and neurological impairment in an infant
Authors: Cervera J, Fischer S, Drozdowski C, Cédola MA
Abstract: Pancytopenia in infants is a serious bone marrow
condition, caused by different entities of varying
severity and different therapeutic response according
to their origin. We present an infant with pancytopenia.
Concomitant neurological symptoms, progressive
muscle weakness and evidence of seizure equivalents,
guided suspicion of neurovitamin disorder, supported
by the morphology of anemia in peripheral blood and
bone marrow. B12 vitamin and carnitine deficit was
found. The initial microangiopathic morphology was
suspicious of renal origin, having found association
with B12 vitamin deficiency and SHUa in the
literature. Renal failure was ruled out, although some
laboratory parameters remained under strict control
(LDH, renal function). Family study was conducted
and requested on eating habits which, despite not
having vegan /vegetarian profile, lacked essential
nutrients. The therapeutic response to replacement
with B12, folic acid and carnitine was very good with
progressive clinical and hematologic improvement.
Weight progress was good, with ad integrum recovery
of some maturational patterns and persistence of
slight weakness of lower limbs after 3 months of
treatment. Her mother carried a B12 vitamin deficit
without anemia or alterations in red cell morphology,
being referred to gastroenterology, requesting factor
intrinsic antibody dosage.
Key words: Pancytopenia,
B12 vitamin,
Neurological impairment.
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