You are what you eat: ophthalmological manifestations of severe B 12 deficiency

BMJ Case Rep. 2017 May 6;2017:bcr2016218558. doi: 10.1136/bcr-2016-218558.

Abstract

Severe B12 vitamin deficiency due to diminished dietary intake is a known cause of severe pancytopenia with bleeding diathesis. The authors report a case with sudden-onset bilateral vision loss, severe pancytopenia and multiple organ failure secondary to B12 vitamin deficiency in a patient with a strict vegetarian diet. On funduscopic examination the patient had multiple bilateral exuberant haemorrhages in all retinal layers. Five months after presentation, he had a complete visual recovery without ophthalmological intervention.

Keywords: Haematology (incl blood transfusion); Malnutrition; Ophthalmology; Retina.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aftercare
  • Diagnosis, Differential
  • Diet, Vegetarian / adverse effects*
  • Feeding Behavior / physiology
  • Humans
  • Hydroxocobalamin / administration & dosage
  • Hydroxocobalamin / therapeutic use*
  • Injections, Intramuscular
  • Life Support Care / methods
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology
  • Pancytopenia / drug therapy*
  • Pancytopenia / etiology
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / etiology
  • Treatment Outcome
  • Vision Disorders / diagnosis
  • Vision Disorders / etiology
  • Vitamin B 12 / blood
  • Vitamin B 12 Deficiency / complications*
  • Vitamin B 12 Deficiency / diagnosis

Substances

  • Vitamin B 12
  • Hydroxocobalamin