The effects of dietary vitamin B12 deficiency on sperm maturation in developing and growing male rats

ABSTRACT  To evaluate the role of vitamin B₁₂ on spermatogenesis, the effects of dietary vitamin B₁₂ deficiency on sperm maturation in developing rat fetuses and young growing rats were examined. The vitamin B₁₂-defi-cient diet was given to all the animals for three different periods: whole period (gestation to mature), gestation period (gestation to weaning), or immature period (3–12 weeks postnatal). Sperm examination revealed that the sperm count was markedly lower in male progeny (F1) that were vitamin B₁₂-deficient during the whole period. In addition, a significantly higher number of abnormal sperm, such as tailless and amorphous sperm, was observed. In male rats that were vitamin B₁₂-deficient during the immature period, the incidence of abnormal sperms was 14.4% and 4.8% for tailless and short tail, respectively. The motion rates, such as path velocity and straight line velocity, were decreased to 20–40% of the control value in rats that were vitamin B₁₂-deficient both during the whole and gestation periods. However, no effects of vitamin B₁₂ deficiency on sperm motility were observed during the immature and mature periods. From these findings, we suggest that dietary vitamin B₁₂ deficiency during pregnancy may induce irreversible damage in the germ cells of embryos and affect the maturation of spermatozoa.     

Neglect‐induced pseudo‐thrombotic thrombocytopenic purpura due to vitamin B12 deficiency

Although thrombotic thrombocytopenic purpura (TTP) is rare, early diagnosis and treatment are important for decreasing the mortality rate. Acquired vitamin B12 deficiency is frequently overlooked because of its rarity in developed countries, particularly in children and adolescents. The hematological changes in vitamin B12 deficiency present as megaloblastic anemia, increased lactate dehydrogenase, vasoconstriction, increased platelet aggregation, and abnormal activation of the coagulation followed by microangiopathy as well as neutropenia and thrombocytopenia. We report herein the case of a 15‐year‐old girl who had been neglected, which might have caused pseudo‐TTP through malnutrition, particularly vitamin B12 deficiency. When we encounter cases of TTP in children, clinicians must be aware of the possibility of malnutrition, particularly with vitamin B12 deficiency, even in developed countries, and investigate the cause of malnutrition including neglect.     

Nutritional vitamin B12 deficiency in hospitalized young children

The authors sought to determine prevalence, social, economic, and dietary patterns of young children (n = 20) identified as having vitamin B₁₂ deficiency anemia after admission to their hospital in the last 3 years. The diagnosis of vitamin B₁₂ deficiency was based on symptoms and clinical findings, findings on peripheral blood films and bone marrow aspirates, and serum levels of vitamin B₁₂. The children had been exclusively breast-fed without any animal food supplementation. Serum vitamin B₁₂ levels were also measured in the sera of mothers and found to be low. The authors concluded that vitamin B₁₂ deficiency might be an important health problem among children of mothers who do not consume animal foods adequately.     

A pediatric patient with recurrent pseudotumor cerebri and vitamin B12 deficiency

Pseudotumor cerebri is a syndrome of increased intracranial pressure, normal cerebrospinal fluid values, and a normal cerebral ventricles on brain imaging studies. A patient with a diagnosis of pseudotumor cerebri was admitted to the authors' hospital twice within a 2.5-year interval and treated with vitamin B₁₂ (vit-B₁₂). At the second admission she also presented with a cerebral venous thrombosis that might have been explained by vit-B₁₂ deficiency, homocysteinemia, and an increased level of lipoprotein-a.     

Congenital rickets due to maternal vitamin D deficiency in a sunny island of Greece

A full-term male infant presented with clinical and biochemical findings consistent with the diagnosis of congenital rickets: weak muscle tone, craniotabes, episodes of tremor, hypocalcaemia, elevated serum alkaline phosphatase, secondary hyperparathyroidism, decreased 25-hydroxyvitamin D and normal 1,25-dihydroxyvitamin D serum levels. The mother's history and biochemical findings suggested nutritional vitamin D deficiency. Treatment with calcium and vitamin D resulted in the disappearance of clinical findings of rickets, normalization of the baby's biochemical profile and normal growth. It is surprising that this case occurred in an affluent setting, in the Mediterranean island of Crete, with an abundance of sunlight throughout the year. Conclusion: We report this case in order to emphasize the continuing occurrence of congenital rickets even in populations not considered at risk for hypovitaminosis D. A high index of suspicion is required for prompt diagnosis and treatment, thus preventing complications.     

Maternal vitamin B12 deficiency affects spermatogenesis at the embryonic and immature stages in rats

To evaluate the role of cobalamin (Cbl) on spermatogenesis, the effect of dietary vitamin B(12) deficiency on early spermatogenesis was histologically investigated in male fetuses and newborns in the first filial generation (F(1) males) of rats. There was no difference in the number of gonocytes and supporting cells of Sertoli in the gonad in male fetuses on day 16 of gestation and in the testes in F(1) males at 0 days of age between vitamin B(12)-deficient (VB12-D) and vitamin B(12)-supplemented (VB12-S) groups. However, at 21 days of age, a decreased number of spermatogonia and no spermatocytes were observed in the VB12-D group. Numerous TUNEL positive cells were located among spermatocytes of the spermatogenic epithelium. The ultrastructural features examined using transmission electron microscopy were considered to be indicative of apoptosis. The incidence of seminiferous tubules having apoptotic cells was 51.5% in the VB12-D group. At 60 days of age, aplasia of the spermatids and spermatozoa was detected in the VB12-D group. In the connective tissue between the seminiferous tubules, many interstitial Leydig cells and blood vessels were observed in the VB12-D group, as compared with the VB12-S group. These changes produced by vitamin B(12) deficiency can be reversed by providing a VB12-S diet after weaning at 21 days of age. From these findings, such a vitamin B(12) deficiency during gestation and lactation could affect the germ cells and especially damage spermatocytes in F(1) male rats, which indicates that Cbl may be an essential constituent in the meiosis of spermatogenesis.     

Growth and nutritional intake of infants with congenital heart disease

Summary Poor weight and length gain of infants with congenital heart disease is generally considered to be related to inadequate nutritional intake, but no longitudinal data on growth and nutritional intake of such infants are available. We compared weight, length, subscapular and triceps skinfold thickness, energy and protein intake (24-h dietary intake records) as well as serum prealbumin and albumin of infants with cyanotic heart disease (n=8) or isolated left-to-right shunt (n=8) with those of healthy infants aged (n=8) 45–365 days. Weight, length, and combined (subscapular and triceps) skinfold thickness of the two groups with congenital heart disease (CHD) were significantly less from 183 through 365 days of age. However, energy and protein intake was similar to that of the control group from 45 through 365 days of age. Normal serum prealbumin and albumin in the infants with CHD ruled out protein-calorie malnutrition. It is concluded that a low level of food intake was not the main cause of inadequate growth and of small subcutaneous fat stores in these two small, but homogeneous, groups of infants with CHD.     

晚发性维生素K依赖因子缺乏致婴儿颅内血肿的外科治疗

目的 探讨晚发性维生素Ｋ依赖因子缺乏致婴儿颅内血肿的诊断及治疗。方法 １９９２年１月－１９９８年１２月,外科手术方法治疗４ ３２例并发颅内血肿这晚发性维生素Ｋ依赖因子缺乏症患儿,其中单纯血肿清除９例;血肿清除＋置管引流１３例;单纯钻孔置管引流１０例。结果 ３２例均治愈。２９例获得１－４年随访,其中２３例无任何神经系统后遗症,３例偏瘫,２例智力发育落后,１例癫阐述。     

Severe vitamin B-12 deficiency in a child mimicking thrombotic thrombocytopenic purpura

We report a case of severe vitamin B-12 deficiency in a child who had a clinical presentation of hemolysis and thrombocytopenia that suggested the diagnosis of thrombotic thrombocytopenic purpura (TTP) and was associated with decreased ADAMTS13 activity. In this report, we review vitamin B-12 deficiency in children, the relationship between ADAMTS13 activity and TTP and discuss other conditions associated with decreased ADAMTS13 activity.     

Prevalence and risk factors of vitamin D deficiency rickets in Hokkaido, Japan

Background:  Resurgence of vitamin D deficiency rickets has been recognized worldwide. While many cases of this disease have been reported in Hokkaido, the northern island of Japan, no prevalence data is available. Here, we investigated the prevalence and risk factors of vitamin D deficiency rickets in Hokkaido.
Methods:  A specially designed questionnaire was sent to 84 major pediatric departments of hospitals in Hokkaido to collect information of the confirmed cases between July 1999 and June 2004.
Results:  Sixty-seven hospitals responded to the questionnaire. Of these, 20 hospitals reported 31 confirmed cases. All the patients were infants and toddlers, less than 4 years of age. The prevalence of cases in a recent year was estimated to be nine in 100 000 children under four years of age. Most of the 31 cases in our study were breast-fed. Eleven cases showed signs of malnutrition due to unbalanced diet or dietary restriction. Furthermore, the prevalence of cases was higher in the northeastern region than in the southwestern region. The number of cases increased gradually from the end of winter to spring.
Conclusions:  This is the first report ascertaining the prevalence of vitamin D deficiency rickets in Hokkaido, Japan. Limited exposure to sunlight and inadequate diet in early childhood are key risk factors of this disease. Thus, it is crucial to introduce active recommendations for vitamin D supplementation based on age, residential area, and to advocate public awareness for preventing this disease.     

Ocular health of rural children with special reference to vitamin ‘A’ deficiency

Primary school children of a rural area numbering 400 were screened to assess their ocular health particularly for presence of vitamin ‘A’ deficiency disease. A major proportion of children (33.0%) suffered from trachoma followed by vitamin ‘A’deficiency diseases of eye (20.25%). Most of the children with deficiency disease consumed less than 1400 calories daily in their diet. Serum vitamin ‘A’ levels estimated in limited cases revealed that all children with deficiency diseases had lower values than normal, even those with no manifestations (control) were near the vicinity of lower margin of normal range (10ug/100 ml). Application of primary levels of prevention will help in preventing the common ocular conditions in rural areas.     

Influence of maternal literacy on the nutritional status of preschool children

The impact of maternal literacy status on the nutritional status of preschool children in Parbhani was studied. Results revealed that the children of literate mothers had better anthropometric measurements than children of illiterate mothers. Nutrient deficiency signs especially of protein energy malnutrition were more predominant among the children of illiterate mothers. Food consumption pattern was better in children with literate mothers as compared to children of illiterate mothers. The consumption of milk and milk products, fruits, sugar and jaggery was significantly greater in children with literate mothers.     

Vitamin K prophylaxis and late vitamin K deficiency bleeding in infants: Fifth nationwide survey in Japan

Background: In 1980, the first nationwide survey on late vitamin K deficiency bleeding (VKDB) in infants was conducted in Japan, and it was followed by the second, third and fourth nationwide surveys in 1985, 1988 and 1991, respectively. The fifth nationwide survey was designed to ascertain the epidemiology of late VKDB between January 1999 and December 2004. Patients and methods: Questionnaires were sent to 2161 hospitals in Japan that employed members of the Japan Pediatric Society in March 2005. Responses were received from 1373 hospitals, for a response rate of 63.5%. Results: The total number of reported cases was 71, including 21 idiopathic type and 16 secondary type. The incidence of late VKDB was estimated to be 1.9 cases per 100 000 births (95% confidence interval: 1.2–3.0) during this survey period. In 34 cases, the presence or absence of any underlying disease was not clarified. A total of 67/71 infants were entirely breast‐fed. Intracranial hemorrhaging was observed in 26 (63.4%) out of 41 infants whose bleeding sites were described in the questionnaires. In 63 cases (88.7%) of late VKDB found in the present survey, however, vitamin K had been given at least once either during or after the neonatal period. Conclusions: A reevaluation of the current prophylaxis strategy for late VKDB in infants is necessary.     

Low maternal vitamin B12 status during pregnancy is associated with reduced heart rate variability indices in young children

Vitamin B12 plays a vital role in neuronal development, particularly in myelinogenesis. Demyelination of the autonomic nervous system occurs early in vitamin B12 deficiency. However, the impact of maternal vitamin B12 deficiency during pregnancy on neuronal function in the offspring is poorly documented. The objective of this study was to assess cardiac autonomic nervous activity in children born to mothers with low vitamin B12 status during pregnancy using heart rate variability (HRV) indices in the frequency domain. Seventy‐nine healthy children between 3 and 8 years of age were evaluated from an ongoing birth cohort. The blood sample of the mother had been stored and was analysed for plasma vitamin B12 following enrolment of the child. Subjects were divided, based on the median maternal first trimester vitamin B12 status (114 pmol L^?1), into lower (n = 40) and higher (n = 39) vitamin B12 status groups. A lead II electrocardiogram was recorded in the supine posture and subjected to HRV analysis. Low‐frequency HRV in absolute units was reduced significantly in children of the lower vitamin B12 status group (P = 0.03) and was 53% that of the higher vitamin B12 status group. There was a significant association between low‐frequency and total power HRV with cord blood vitamin B12 levels (ρ = 0.31 and 0.30, both P = 0.03). In summary, children born to mothers with a lower vitamin B12 status have a reduced cardiac sympathetic activity. The long‐term implication of this needs to be evaluated by follow‐up studies.