Relevance of MCV and Knuckle Pigmentation in Early Diagnosis of Vitamin B12 Deficiency in Children

Abstract

Background: Vitamin B12 deficiency is common in children, especially who take strict vegetarian diet.
Limited data is available on relevance of knuckle pigmentation and elevated MCV for early diagnosis in
central India, especially in pediatric population.
Aim: To study association of knuckle pigmentation and elevated MCV with vitamin B 12 deficiency in
children in central India
Method: This was hospital based cross sectional study, carried out from March 2019 to February 2020.
41 children with anemia (Hb < 11 gm%) or knuckle pigmentation or elevated MCV (>100 Fl) or any
combination of these, were enrolled. The association of knuckle pigmentation and elevated MCV with
vitamin B 12 deficiency was studied. Data was analyzed by Chi square test. P value < 0.05 was considered
to be statistically significant.
Results: 29 out of 41 subjects had vitamin B 12 deficiency, maximum of which were strictly vegetarian.
There was statistically significant association between vitamin b12 deficiency with elevated MCV but not
with knuckle pigmentation.
Conclusion: Knuckle pigmentation and elevated MCV value may not be seen in every child with vitamin B
12 deficiency, but their presence gives important clue to early diagnosis and hence leads to early treatment