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Answer to Hypotonia: A Simple Hemogram

Department of Pediatrics Infectious Disease Unit, Hacettepe University School Medicine

Mualla Cetin, MD

Department of Pediatrics Hematology Unit, Hacettepe University School of Medicine

Sule Unal, MD

Department of Pediatrics, Hacettepe University School of Medicine

Goknur Haliloglu, MD

Department of Pediatrics Neurology Unit, Hacettepe University School of Medicine

Tulay Akça, MD

Department of Pediatrics, Hacettept University School of Medicine

Nejat Akalan, MD

Department of Neurosurgery, Hacettepe University School of Medicine

Ates Kara, MD

Department of Pediatrics Pediatrics Infectious Disease Unit Hacettepe University School of Medicine Ankara, Turkey, ateskara{at}hacettepe.edu.tr.

A 1-year-old boy with weight loss, decreased activity, and psychomotor regression is presented. He was subjected to an extremely detailed evaluation, including electroencephalography (EEG) and magnetic resonance imaging (MRI), until a simple hemogram in our center revealed that he had macrocytic anemia with megaloblastic changes in the bone marrow. His history revealed that he had been exclusively breast-fed by his vegetarian mother. Further investigations showed low serum vitamin B₁₂ concentration, methylmalonic aciduria, and homocysteinemia, indicating that the macrocytic anemia was due to vitamin B₁₂ deficiency. This boy represents a case of macrocytic anemia and hypotonia owing to vitamin B₁₂ deficiency that developed because of exclusive breast-feeding by a vegetarian mother. (J Child Neurol 2005;20:930—931).

Journal of Child Neurology, Vol. 20, No. 11, 930-931 (2005)
DOI: 10.1177/08830738050200111501


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