Ifra Sameen, Yasmin Channa.
Study of Vitamin B12 and Folate Levels in Children with Pancytopenia.
Pak Paed J Jan ;39(2):73-9.

We were interested in identifying vitamin B12 and Folate deficiency as a cause of pancytopenia in children, as megaloblastic anemia or aplastic anemia due to vitamin B12 and Folate deficiency is a treatable cause of aplastic anemia. Objective: To identify vitamin B12 and or Folate deficiency as a cause of pancytopenia in children and to assess the therapeutic response to oral vitamin B 12 and Folate therapy. Study Design: Descriptive Study Place & Duration of Study: National Institute of Child Health Karachi, from July 2009 to June 2010 Patients And Methods: Children fulfilling the inclusion criteria: clinical features of pancytopenia like fever, pallor and bleeding manifestations and two or more cell lines depressed on blood counts were included. Bone marrow aspiration was done in all patients. Serum vitamin B12 and Folate levels were obtained in patients whom prior to transfusion samples were available. All patients were then placed on oral vitamin B12 and Folic acid along with dietary therapy. Hematological support was also given in few cases. Results: Twenty-six children with pancytopenia were found having Vitamin B12 and or folate deficiency. Number of male and female was equal. Seven children had low plasma concentration of vitamin B12; three children had low concentration of Folate, whereas 12 patients had low concentration of both vitamin B12 and Folate. Among 26 patients with B12 and folate deficiency 17 also had severe malnutrition. All children responded to one-month oral therapy of vitamin B12 and Folic acid. Conclusion: Pancytopenia due to vitamin B12 and folate deficiency is more common in malnourished children. Treatment with oral supplementation of vitamin B12 and folic acid is safe and effective.

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