Persistent diarrhea, hemolytic anemia, and splenohepatomegaly due to Vitamin B12 deficiency in an infant

Vitamin B12 is essential for DNA and RNA synthesis. Vitamin B12 deficiency usually occurs in infants who are exclusively breastfed born to Vitamin B12-deficient mothers. Even though macrocytic anemia is the classic feature, the spectrum of hematological findings due to Vitamin B12 deficiency ranges from simple macrocytosis to life-threatening hemolytic anemia. Other manifestations of Vitamin B12 deficiency in infants include delay in growth and development, anorexia, diarrhea, sparse hair, failure to thrive, abnormal pigmentation, hypotonia, and enlarged liver and spleen. Herewith, we are presenting a 6-month-old child with growth retardation, persistent diarrhea, anorexia, irritability, anemia, and splenohepatomegaly due to Vitamin B12 deficiency who responded to Vitamin B12 therapy.