Vitamin B-12 is absorbed from the terminal ileum, which is a commonly affected segment of gut in Crohn’s disease. Its absorption may be compromised in these children secondary to inflammatory lesions, ileal bacterial overgrowth, or mucosal damage caused by reflux of bacteria and surgical resection.1 Of these, surgical resection of large segments of terminal ileum remains the most important cause of B-12 malabsorption in such patients. Prolonged depletion leads to megaloblastic anaemia and ultimately neuropathy and myelopathy. Therefore, diagnosis and treatment of vitamin B-12 malabsorption in patients with Crohn’s disease and small bowel/ileal resection is of great importance.
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