Titre : | Functional vitamin B12 deficiency is a consistent feature in hospital admissions for neurological disorders due to the use of nitrous oxide (2023) |
Auteurs : | E. MONDESERT ; C. EIDEN ; H. PEYRIÈRE ; A. FORMOSO ; L. CORTI ; J. P. CRISTOL ; S. BADIOU |
Type de document : | Article : Périodique |
Dans : | Clinical Toxicology (Vol.61, n°9, September 2023) |
Article en page(s) : | 674-679 |
Langues: | Anglais |
Discipline : | PRO (Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods) |
Mots-clés : |
Thésaurus géographique FRANCEThésaurus mots-clés ETUDE RETROSPECTIVE ; ADMISSION ; HOPITAL ; PROTOXYDE D'AZOTE ; VITAMINES ; CARENCE ; NEUROLOGIE ; ETUDE CLINIQUE ; METABOLISME ; ANALYSE CHIMIQUE ; EFFET SECONDAIRE |
Résumé : |
Introduction: Misuse of inhaled nitrous oxide is a growing concern in France. It is known to alter concentrations of vitamin B12 which is required as a cofactor for methionine synthase and methylmalonyl-CoA mutase activity. Hence, measurement of the concentrations of cobalamin metabolism biomarkers, including vitamin B12, homocysteine, and methylmalonic acid, could assist in the management of patients with a complex clinical presentation or in those who deny the consumption of nitrous oxide.
Methods: We retrospectively collected clinical and biological data in patients hospitalized for nitrous oxide use in a university hospital in southern France between January 2020 and October 2022. Results: Thirty-one patients were identified during 34 months; 79% were men with a median age of 23.7 years. Most (97%) presented with peripheral polyneuropathy and/or myelopathy. The median vitamin B12 concentration was 134.6 pmol/L, with 17 of 31 patients having values less than 145 pmol/L (the lower limit of the normal range). The median plasma folate concentration was 20.1 nmol/L, which is within the normal range. The median plasma homocysteine concentration was 87.7 µmol/L (normal range >15 µmol/L), and the median plasma methylmalonic acid concentration was 3.8 µmol/L (normal range >0.5 µmol/L). Conclusion: Nitrous oxide use is an emerging public health problem in France, as shown by the number of patients admitted to our hospital. The presence of a functional vitamin B12 deficiency was a consistent feature that could be helpful in diagnosis in complex cases. |
Domaine : | Autres substances / Other substances |
Refs biblio. : | 33 |
Affiliation : |
Department of Biochemistry, University Hospital of Montpellier, Montpellier, France Addictovigilance Center, Department of Pharmacology and Toxicology, University Hospital of Montpellier, Montpellier, France Department of Neurology, University Hospital of Montpellier, Montpellier, France PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France |
Lien : | https://doi.org/10.1080/15563650.2023.2274282 |
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