ESPE2023 Poster Category 2 Fetal, Neonatal Endocrinology and Metabolism (6 abstracts)
When the infant makes the diagnosis of Biermer's disease of his mother
Ahlem Kefi 1 , Asma Marzouk 2,1 , Altaf Gaarbaa 1 , Rahma Thebti 1 , Mariem Laajili 2 , Oumaima Mzoughi 1 , Sarra Ben Hssine 1 , Farida Friha 1 & Asma Bouaziz 1,2
1Department of Paediatrics and Neonatology Yasminette Ben Arous, Ben Arous, Tunisia. 2El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
Introduction: The nutritional status of young breastfed infants is sometimes dependent on the nutritional status of their mothers. Investigation of poor infant weight gain should take into account possible nutritional diseases of the mothers including Biermer's disease.
Objective: through a clinical case, remind the importance of exploring the nutritional status of mothers of exclusively breastfed infants with poor weight growth.
Observation: We report the case of a 4-month-old infant followed for weight stagnation. The clinical examination showed: weight at -2 DS, pallor, disappearance of the smile-response, axial hypotonia and sharp osteotendinous reflexes. The blood count showed pancytopenia. A myelogram was performed and showed a rich marrow with cellular gigantism and asynchronous nucleo-cytoplasmic maturation affecting all lineages. The infant's plasma vitamin B12 level was collapsed with hyper-homocysteinemia confirming the diagnosis of vitamin B12 deficiency. Brain MRI was normal. The digestive fibroscopy showed a non-specific oedematocongestive duodenitis. The anti-FI antibody test was negative and the anti-stomach parietal cell antibody test was significantly elevated. The mother's blood count showed an isolated macrocytosis. Her vitamin B12 blood level was collapsed. The vitamin B12 deficiency of the infant, was related to exclusive breastfeeding in a non-vegetarian mother with unrecognised Biermer disease. Improvement in clinical symptoms (weight growth and psychomotor development) and haematological symptoms was rapidly observed under vitamin B12 treatment.
Conclusion: A delay in weight growth associated with a delay in psychomotor development in an infant, whether or not it is associated with a haematological anomaly, should necessarily prompt us to look for a vitamin B12 deficiency mainly of maternal origin.
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