# A Rare Cause of Vitamin B12 Deficiency in the Pediatric Age

## TL;DR

A 17-year-old refugee in Portugal developed vitamin B12 deficiency due to chronic alcohol use, highlighting the need for awareness in adolescents.

## Contribution

This case highlights chronic alcohol use as a rare but important cause of vitamin B12 deficiency in adolescents.

## Key findings

- A 17-year-old adolescent developed vitamin B12 deficiency due to excessive alcohol consumption.
- Oral vitamin B12 supplementation was effective in replenishing levels after four months.
- The case emphasizes the importance of considering risky behaviors in diagnosing vitamin B12 deficiency in adolescents.

## Abstract

Vitamin B12 plays an important role in DNA synthesis, hematopoiesis, and neuronal mechanisms, and its deficiency can be associated with insufficient intake or poor absorption and autoimmune and genetic diseases. Although rare, excessive, and chronic alcohol consumption may also justify a deficiency in this vitamin. We present a case of a 17-year-old Iraqi adolescent refugee in Portugal with a deficiency of vitamin B12 due to excessive and chronic alcohol consumption. Although intramuscular (IM) supplementation with cyanocobalamin is the most used, it was decided to initiate oral supplementation. After four months, vitamin B12 levels were replenished. With this clinical case, we aim to raise awareness of the cause of cyanocobalamin deficiency, which although rare in pediatric age should be considered in adolescents, given the possibility of risky behaviors in this age group. Additionally, given the therapeutic options, we have found that oral administration of vitamin B12 has been effective, as reported in the literature.