Skip Navigation LinksHome > May 2010 - Volume 32 - Issue 4 > Varicella Zoster Virus-induced Hemolytic Crisis in an Infant...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e3181ced271
Clinical and Laboratory Observations

Varicella Zoster Virus-induced Hemolytic Crisis in an Infant With Severe Vitamin B 12 Deficiency

Lombardi, Francesca MD*; Quitadamo, Anna Lucia MD*; Notarangelo, Lucia Dora MD; Pelizzoni, Alessandra MD; Accorsi, Paola MD*; Olivetti, Franco MD*; Schumacher, Richard Fabian MD

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Abstract

Background: Vitamin B 12 deficiency is an uncommon disorder in infancy. Most cases are because of maternal deficiency resulting from insufficient storage and/or reduced intake and are generally seen in exclusively breast-fed infants. Accentuation of the hemolytic process has never been described in association with Varicella Zoster Virus (VZV) infections.

Observation: We describe a 9-months-old breast-fed infant with megaloblastic anemia secondary to maternal vitamin B 12 deficiency. He presented severe pancytopenia and regression of motor functions and developed hemolytic crisis during a VZV infection.

Conclusions: Nutritional cobalamin deficiency should be considered in anemic infants with a history of prolonged exclusive breastfeeding and delayed developmental milestones. VZV infection can trigger a hemolytic process in infants with severe megaloblastic anemia secondary to B12 deficiency. A normal mean corpuscular volume does not rule out megaloblastic anemia, when the condition is combined with severe hemolysis.

© 2010 Lippincott Williams & Wilkins, Inc.

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