Neurologic Disease and Vitamin B12 Levels in Children.

Introduction

Vitamin B12 deficiency is a well-known cause of neurologic symptoms, prompting routine measurement in patients with neurologic conditions. However, elevated B12 levels are also observed in some cases. Recent studies suggest a potential link between high B12 levels and neurologic or neurodevelopmental disorders. This study aims to evaluate vitamin B12 levels in children with neurologic disorders compared with those in general pediatric populations. Materials and

Methods

This single-center retrospective study analyzed pediatric patients' vitamin B12 levels between 2000 and 2023. Exclusion criteria included incomplete data and vitamin supplementation. Patients were grouped based on B12 levels (<200 pg/mL, 201-660 pg/mL, 661-1000 pg/mL, > 1000 pg/mL). Age, gender, and diagnoses were assessed, focusing on patients with elevated B12 levels (>660 pg/mL) in the neurology clinic. Vitamin B12 levels were measured using Roche Cobas e 601 analyzers.

Results

Over 3 years, 4142 pediatric clinic and 2638 pediatric neurology patients were reviewed. Elevated B12 levels were more frequent in the neurology clinic. Patients with elevated B12 levels (n = 338) had a mean age of 8.67 months and a mean B12 level of 894.7 pg/mL. Of 137 patients with follow-up B12 measurements, 40.1% normalized, while 17.5% remained > 1000 pg/mL. The most common diagnosis in patients with persistently high B12 levels was epilepsy, followed by prematurity, cerebral palsy, autism, intellectual disability, and language delay.

Conclusions

Elevated vitamin B12 levels were associated with pediatric neurologic disorders, particularly epilepsy. Further research is needed to clarify the mechanisms and clinical implications of this finding.