Methylene Tetrahydrofolate Reductase Deficiency: the Hidden Risk in Paediatric Anaesthesia

Orhon, Zeynep Nur; Koltka, Emine Nursen; Tüfekçi, Sevil; Buldag, Cigdem; KISA, A. Cansu GÖK; Durakbaşa, Çiğdem Ulukaya; Çelik, Melek Güra

doi:10.5152/tjar.2017.68366

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…A possible explanation for the severe toxicity seen in this patient is undiagnosed homozygosity for MTHFR, which can result in similar neurotoxicity without invoking nitrous as a cause . MTHFR deficiency is not an uncommon finding and these patients can be safely sedated with propofol . The patient was noted to have a low‐serum vitamin B‐12 week after the event possibly related to the use of omeprazole.…”

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confidence: 99%

Reply to: Comment on: Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics

Bostrom

Livingston

McAllister

2018

Pediatric Blood & Cancer

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confidence: 99%

Reply to: Comment on: Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics

Bostrom

Livingston

McAllister

2018

Pediatric Blood & Cancer

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Pharmacologic Management of the Pediatric Patient with Special Healthcare Needs

Tom

2019

Dental Care for Children With Special Needs

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The effects of gasotransmitters inhibition on biochemical and haematological parameters and oxidative stress in propofol-anaesthetized Wistar male rats

Djurić

Turnic

Kostic

et al. 2019

Can. J. Physiol. Pharmacol.

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This study aimed to investigate the effects of propofol through evaluating its interaction with nitric oxide (NO), hydrogen sulfide (H2S), and carbon monoxide (CO). Wistar male rats were divided in 4 groups: (1) bolus injection of propofol (1% 10 mg/mL, 100 mg/kg bw, i.p.); (2) Nω-nitro-l-arginine methyl ester (L-NAME; NO synthase inhibitor, 60 mg/kg bw, i.p.) + bolus injection of propofol (1% 10 mg/mL, 100 mg/kg bw, i.p.); (3) DL-propargylglycine (DL-PAG; H2S synthase inhibitor, 50 mg/kg bw, i.p.) + bolus injection of propofol (1% 10 mg/mL, 100 mg/kg bw, i.p.); (4) zinc protoporphyrin IX (ZnPPIX; CO synthase inhibitor, 50 μmol/kg bw, i.p.) + bolus injection of propofol (1% 10 mg/mL, 100 mg/kg bw, i.p.). Increased levels of albumins, low-density lipoproteins, alkaline phosphatase, amylase, high-sensitivity Troponin T, and fibrinogen were found in L-NAME + propofol group. Platelet crit, platelet count, total cholesterol, and high-density lipoproteins were elevated in ZnPPIX + propofol group. Hydrogen peroxide was increased in all groups treated with gasotransmitters inhibitors. Reduced glutathione was reduced in all groups, superoxide dismutase activity only in L-NAME + propofol. The effect of propofol on various biochemical, haematological, and oxidative stress markers may be at least in part mediated through interaction with 3 estimated gasotransmitters.

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Methylene Tetrahydrofolate Reductase Deficiency: the Hidden Risk in Paediatric Anaesthesia

Abstract: Sevoflurane and propofol have no deleterious effects on homocysteine levels in patients with MTHFR deficiency. Avoidance of NO is the key point for anaesthetic consideration regarding these patients.

Cited by 4 publications

References 10 publications

Reply to: Comment on: Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics

Reply to: Comment on: Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics

Pharmacologic Management of the Pediatric Patient with Special Healthcare Needs

The effects of gasotransmitters inhibition on biochemical and haematological parameters and oxidative stress in propofol-anaesthetized Wistar male rats

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