{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:46:24Z","timestamp":1792003584131,"version":"4.4.0"},"reference-count":15,"publisher":"Universa BV","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AGEB"],"published-print":{"date-parts":[[2021,2,16]]},"abstract":"<jats:p>Cobalamin or vitamin B12 (vitB12) is involved in DNA synthesis, haematopoiesis and myelinisation. Consequently, vitB12 deficiency causes various symptoms, such as megaloblastic anaemia, neurologic signs or pancytopenia. Despite possible severe symptoms, vitB12 deficiency can present asymptomatically. We report six paediatric patients with different aetiologies of vitB12 deficiency ranging from a subtle to a more overt presentation. VitB12 deficiency is a diagnostic challenge due to the lack of consensus on normal values of vitB12 and its co-markers (folate, holotranscobalamin, methylmalonic acid, homocysteine) and the lack in specificity and sensitivity of the serum vitB12 analysis. All cases were treated with parenteral vitB12. Last decades, evidence supporting high dose oral treatment being as effective as the intramuscular (IM) therapy, also in children, is growing.<\/jats:p>","DOI":"10.51821\/84.1.753","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T20:46:50Z","timestamp":1620852410000},"page":"121-124","source":"Crossref","is-referenced-by-count":9,"title":["Vitamine B12 deficiency in children : a diagnostic challenge"],"prefix":"10.51821","volume":"84","author":[{"given":"J","family":"Van Vlaenderen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Christiaens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Van Winckel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"De Bruyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Vande Velde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Van Biervliet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27062","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"VAN WINCKEL M, VANDE VELDE S, DE BRUYNE R, VAN BIERVLIET S. Clinical practice : vegetarian infant and child nutrition. European journal of pediatrics, 2011, 170(12) : 1489-94.","DOI":"10.1007\/s00431-011-1547-x"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"STABLER SP. Clinical practice. VitB12 deficiency. The New England journal of medicine, 2013, 368(2) : 149-60.","DOI":"10.1056\/NEJMcp1113996"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"IDE E, VAN BIERVLIET S, THIJS J, VANDE VELDE S, DE BRUYNE R, VAN WINCKEL M. Solid food refusal as the presenting sign of vitB12 deficiency in a breastfed infant. European journal of pediatrics, 2011, 170(11) : 1453-5.","DOI":"10.1007\/s00431-011-1522-6"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"GRASBECK R. Imerslund-Grasbeck syndrome (selective vitamin B(12) malabsorption with proteinuria). Orphanet journal of rare diseases, 2006, 1 : 17.","DOI":"10.1186\/1750-1172-1-17"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"SHIPTON MJ, THACHIL J. VitB12 deficiency - A 21st century perspective. Clinical medicine (London, England), 2015, 15(2) : 145-50.","DOI":"10.7861\/clinmedicine.15-2-145"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"APARICIO-UGARRIZA R, PALACIOS G, ALDER M, GONZALEZ-GROSS M. A review of the cut-off points for the diagnosis of vitB12 deficiency in the general population. Clinical chemistry and laboratory medicine, 2015, 53(8) : 1149-59.","DOI":"10.1515\/cclm-2014-0784"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"DEVALIA V, HAMILTON MS, MOLLOY AM, British Committee for Standards in H. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. British journal of haematology, 2014, 166(4) : 496-513.","DOI":"10.1111\/bjh.12959"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"WANG H, LI L, QIN LL, SONG Y, VIDAL-ALABALL J, LIU TH. Oral vitB12 versus intramuscular vitB12 for vitB12 deficiency. The Cochrane database of systematic reviews, 2018, 3 : CD004655.","DOI":"10.1002\/14651858.cd004655.pub3"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"VIDAL-ALABALL J, BUTLER CC, POTTER CC. Comparing costs of intramuscular and oral vitB12 administration in primary care : a cost-minimization analysis. The European journal of general practice, 2006, 12(4) : 169-73.","DOI":"10.1080\/14017430601049449"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"VERMA D, CHANDRA J, KUMAR P, SHUKLA S, SENGUPTA S. Efficacy of oral methylcobalamin in treatment of vitB12 deficiency anemia in children. Pediatric blood & cancer, 2017, 64(12).","DOI":"10.1002\/pbc.26698"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"SEZER RG, AKOGLU HA, BOZAYKUT A, OZDEMIR GN. Comparison of the efficacy of parenteral and oral treatment for nutritional vitB12 deficiency in children. Hematology (Amsterdam, Netherlands), 2018, 23(9) : 653-7.","DOI":"10.1080\/10245332.2018.1456023"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"BAHADIR A, REIS PG, ERDURAN E. Oral vitB12 treatment is effective for children with nutritional vitB12 deficiency. Journal of paediatrics and child health, 2014, 50(9) : 721-5.","DOI":"10.1111\/jpc.12652"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"SEZER RG, BOZAYKUT A, AKOGLU HA, OZDEMIR GN. The Efficacy of Oral VitB12 Replacement for Nutritional VitB12 Deficiency. Journal of pediatric hematology\/oncology, 2018, 40(2) : e69-e72.","DOI":"10.1097\/mph.0000000000001037"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"ALTAY C, CETIN M. VitB12 absorption test and oral treatment in 14 children with selective vitB12 malabsorption. Pediatric hematology and oncology, 1999, 16(2) : 159-63.","DOI":"10.1080\/088800199277489"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"CHANDELIA S, CHANDRA J, NARAYAN S, ANEJA S, CHAWLA HM, SHARMA S, et al. Addition of cobalamin to iron and folic acid improves hemoglobin rise in nutritional anemia. Indian journal of pediatrics, 2012, 79(12) : 1592-6","DOI":"10.1007\/s12098-012-0725-9"}],"container-title":["Acta Gastro Enterologica Belgica"],"original-title":[],"language":"en","deposited":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T20:46:55Z","timestamp":1620852415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ageb.be\/ageb-journal\/ageb-volume\/ageb-article\/1885\/Vitamine%20B12%20deficiency%20in%20children%20:%20a%20diagnostic%20challenge\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,16]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,2]]},"published-print":{"date-parts":[[2021,2,16]]}},"URL":"https:\/\/doi.org\/10.51821\/84.1.753","relation":{},"ISSN":["1784-3227"],"issn-type":[{"value":"1784-3227","type":"print"}],"subject":[],"published":{"date-parts":[[2021,2,16]]}}}