Vitamin B12 deficiency-induced megaloblastic anemia in a pediatric patient with autism spectrum disorder with a chronically unbalanced diet

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of behavioral flexibility and stereotyped language. Food selectivity is common among children with ASD because of their persnickety nature. A prolonged unbalanced diet results in an increased risk of several dise...

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Bibliographic Details
Published in:International journal of hematology 2024-05, Vol.119 (5), p.613-616
Main Authors: Sawada, Yuri, Sakamoto, Kenichi, Tsukamura, Atsushi, Sawai, Chihiro
Format: Article
Language:English
Subjects:
Anemia
Anemia, Megaloblastic - etiology
Autism
Autism Spectrum Disorder - complications
Case Report
Child
Cyanocobalamin
Deficiency diseases
Diet
Dietary Supplements
Food selection
Hematology
Humans
Iron deficiency
Male
Medicine
Medicine & Public Health
Neurodevelopmental disorders
Nutrient deficiency
Nutritional status
Oncology
Patients
Pediatrics
Rickets
Selectivity
Vitamin B 12 Deficiency - complications
Vitamin B12
Vitamin deficiency
Wernicke's encephalopathy
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Summary:Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of behavioral flexibility and stereotyped language. Food selectivity is common among children with ASD because of their persnickety nature. A prolonged unbalanced diet results in an increased risk of several diseases, such as iron deficiency anemia, scurvy, rickets, dry eye, and Wernicke encephalopathy. However, no cases of megaloblastic anemia have been reported to date. We report the case of an 11-year-old boy with ASD who developed megaloblastic anemia due to vitamin B12 deficiency. He had a prolonged history of selective eating for more than 10 years. His nutritional status on admission was poor, and he had low weight and short stature. His food selectivity was so strong that intervention to expand diet variety was unsuccessful. A developmental-behavioral pediatrician found that the patient had visual dominance and could take some medications when suffering from a minor illness. Nutritional supplements were selected after consultation with a nutritionist. Although compulsory treatment was necessary during the acute phase, the therapy was continued at home. With multidisciplinary intervention tailored to the patient and his parents’ characteristics, his nutritional status improved in a few months.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-024-03759-3