P2 – 2736: Vitamin B12 deficiency and neurologic findings: Retrospective analysis of 124 patients

Abstract

Objective Vitamin B12 is essential for the development and initial myelination of the central nervous system. Because methylation reactions are important in many parts of the central nervous system, deficiency of vitamin B12 deficiency leads to a wide range of neurological symptoms. Methods A total of 124 of 7007 children aged 6th month and 18 years old who addmitted to outpatient child neurology clinic of Giresun Prof. Dr. A.Ilhan Ozdemir State Hospital between September 15th 2014 and January 15th 2015 were selected retrospectively according to neurologic sign and symptoms of vitamin B12 deficiency. Patients who has neurological symptoms of vitamin B12 deficiency together with low B12 and/or elevation of homocysteine levels in serum were objected to the study. Patients were classified as six groups concerning neurological symptoms. Results A total of 124 patients were meet the selection criterias. Male and female patients were 47 and 77 in number respectively with mean age 13.5 (6th month – 18) and mean vitamin B12 levels was 164.9 pg/ml. Although 19 of 124 patients who had vitamin B12 level above 192 pg/ml, they had increased homocystein level concerning age limits. All of 19 patients had neurological symptom and sign of vitamin B12 deficiency. The most frequent signs were dizziness and/or syncope (77/124 patients, 62%) belonging the group III is composed of 77 patient including 23 patient with syncope and 54 patient with dizziness. Conclusion Investigation of vitamin B12 level is essential as a screening test in children with syncope and dizziness, It is useful to insist on investigation of homocysteine level in patients with clinical symptoms and/or signs of vitamin B12 deficiency even with normal vitamin B12 level. We conclude that a normal total blood count is not enough to exclude of diagnosis of vitamin B12 deficiency in children with neurological symptoms.