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Vitamin B₁₂ and Folic Acid in Children with Intestinal Parasitic Infection

Department of Paediatrics (J.L.O., R.F., J.F., M.Y.R.), "Lozano Blesa" Hospital, University of Zaragoza School of Medicine, Zaragoza, SPAIN
Microbiology (A.C.), "Lozano Blesa" Hospital, University of Zaragoza School of Medicine, Zaragoza, SPAIN

Address correspondence to: José L. Olivares MD, PhD, Departamento de Pediatría, Facultad de Medicina, Universidad de Zaragoza, C/. Domingo Miral s/n, 50009 Zaragoza, SPAIN. E-mail: olivares{at}posta.unizar.es

Objective: To determine prospectively plasma levels of vitamin B₁₂ and folic acid in children with intestinal parasitic infection before and three months after antiparasitic treatment.

Methods: 3036 stool samples were collected from 1959 children and 939 cello-tape anal swabs were taken from 688 children for intestinal parasite investigation. Of these, 155 children were identified as having a parasitic infection; however, only 86 were followed up during this study: 26 children with Giardia lamblia infection were treated with tinidazole and metronidazole, pyrantel pamoate was used in the treatment of 40 children with Enterobius vermicularis, and 20 patients infected with Cryptosporidium parvum received only symptomatic treatment. Vitamin B₁₂ and folic acid levels were measured by radioimmunoassay, before and three months after the completion of treatment.

Results: Vitamin B₁₂ serum concentrations did not show any significant differences among the three groups. There was a significant increase in vitamin B₁₂ serum concentrations after three months of anti-parasitic treatment (630.57 ± 200.97 vs. 667.97 ± 181.55 pg/dL, p = 0.002, n = 86). Paired analysis in each group showed only significant increases for vitamin B₁₂ in the Giardia lamblia group and in the Enterobius vermicularis group. No statistically significant differences were found for folic acid serum concentrations before and three months after treatment.

Conclusions: Patients with symptomatic infection by Giardia lamblia and Enterobius vermicularis have lower vitamin B₁₂ levels than asymptomatic patients. This could reflect a more affected intestinal mucous. These results could present the opportunity to treat these parasitic infections and to use vitamin B₁₂ supplementation in symptomatic children with Giardia lamblia and Enterobius vermicularis infection.

Key words: vitamin B₁₂, folic acid, Giardia lamblia, Crypstosporidium parvum, Enterobius vermicularis

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