Megaloblastic anemia in childhood is uncommon and usually due to nutritional deficiency rather than to congenital metabolic disease.1 Individuals who subsist on diets that exclude eggs, meat, and dairy products are known as vegans and are particularly susceptible because of a virtually complete lack of dietary vitamin B12. A case of profound vitamin B12 deficiency in the exclusively breast-fed infant of a vegan, manifesting the triad of megaloblastic anemia with pancytopenia, aminoaciduria, and neurologic changes, is reviewed to alert physicians to this easily preventable nutritional problem and to the need for early parental counseling and dietary supplementation.
Report of a Case.—A previously well 6-month-old boy was admitted to Children's Hospital Medical Center, Oakland, Calif, because of severe anemia. The patient was the product of an uncomplicated full-term pregnancy and delivery. The family had been strict vegans for a period of seven years, and the infant had