A retrospective evaluation of the effectiveness of oral cobalamine treatment in children aged 6-18 years wi̇th nutritional vitamin B12 deficiency

Objective: Orally administered vitamin B12 treatment is a more suitable option for children to adapt to the treatment. In this study, it was aimed to retrospectively evaluate the effectiveness of oral vitamin B12 treatment conducted on children aged 6-18 years with nutritional vitamin B12 deficiency. Materials and methods: The files of 6-18 age group patients who were followed up and treated with the diagnosis of vitamin B12 deficiency at Karadeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology between January 2010 and January 2018 were analyzed retrospectively. Results: In our study, the most common complaints were as follows: headache (28.8%), dizziness (11.5%), weakness (10.8%), and syncope (9.5%). Patients were diagnosed with high RDW in 24.1%, anemia in 18.8%, lymphopenia in 7.5%, macrocytosis in 3.1%, neutropenia in 2.8% and thrombocytopenia in 2.7%. In addition, homocysteine elevation was found in 30.1% and urinary MMA elevation in 15.6% of the patients. When all patients were evaluated regardless of their age groups, serum vitamin B12 levels which are evaluated after treatment and Hb values increased. Although these values were found to be significantly higher (p <0.05) compared to the values before the treatment, the mean serum B12 levels were 191.4 pg/ml (<200 pg/ml). In maintenance treatment, the success rate of 1000 mcg cyanocobalamin treatment given for 4 months, once-a-week was 27.7%. Conclusion: Although oral treatment is effective in the treatment of nutritional vitamin B12 deficiency, it has been concluded that a 4-month, once-a-week maintenance treatment is not sufficient in 6-18 age group patients. Therefore, we believe that it will be more appropriate to offer an oral vitamin B12 maintenance treatment more frequently than once a week. Keywords: Vitamin B12, treatment, cyanocobalamin, child, oral