Profound Vitamin B12 Deficiency in a 1-Year-Old Child in Botswana: A Call to Initiate Early Empiric Therapy.

Vitamin B12 deficiency is a rare diagnosis in young children. We present the case of a 1-year-old Zimbabwean child with profound anemia. Further testing revealed undetectable levels of vitamin B12 and positive intrinsic factor antibodies that were drawn after the initiation of empiric treatment with parenteral vitamin B12. We report the evaluation and management of vitamin B12 deficiency in a resource-limited setting. Vitamin B12 deficiency should be considered in children presenting with unexplained cytopenias with consideration of empiric treatment with parenteral vitamin B12, as developmental and neurological complications of vitamin B12 deficiency can be devastating and permanent.