A 10-year-old boy with cystic fibrosis presents with progressive gait instability and loss of vibration sense in the lower extremities. Vital signs are stable (BP 110/68, HR 88, RR 20, Temp 37°C, SpO2 98% on room air). Laboratory studies reveal hemoglobin 10.2 g/dL with normal MCV and reticulocyte count of 2.8%. Peripheral blood smear shows schistocytes. He denies recent infections. Which nutrient deficiency best explains these neurologic and hematologic findings?
- A)Vitamin B6
- B)Vitamin B12
- C)Folate
- D)Vitamin B1
- E)Vitamin EGABARITO
Explicação
Vitamin E is the correct answer because deficiency can cause posterior column and spinocerebellar dysfunction with ataxia and vibration loss, and it may also cause hemolytic anemia due to oxidative damage to red blood cells. Ver explicação completa e trilha adaptativa →