Vitamin B12 Deficiency Resembling Acute Leukemia: A Case Report

Sharma, Nisha; Kunwar, Saru; Shrestha, Anil

doi:10.31729/jnma.6600

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Oussalah et al demonstrated in their 2019 systematic review that, in addition to neurological damage, patients who had suffered N2O poisoning had at least one haematological alteration in 71.7% of cases, the 3 main alterations are a drop in haemoglobin level (55.8%), a drop in haematocrit (52.4%) and macrocytosis (41.8%) [ 3 ]. Vitamin B12 deficiency is well recognised as an aetiology of pancytopenia with several cases reported in the literature describing an acute leukaemia-like clinic [ 21 – 23 ]. To date, only two cases of pancytopenia due to vitamin B12 deficiency induced by recreational use of N2O have been reported [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Nitrous oxide-induced polyneuropathy, pancytopenia and pulmonary embolism: a case report

Parein,

Bollens

2023

J Med Case Reports

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Background Nitrous oxide is a medical and household gas that has seen its use drift to recreational purpose among the young population in recent years. Significant neurological, hematological and psychiatric side effects, generally related to an induced functional vitamin B12 deficiency, have been described separately in the literature. Case report A 22-year-old woman of North African origin experienced an exceptional combination of polyneuropathy, bilateral pulmonary embolism and severe pancytopenia related to vitamin B12 deficiency and hyperhomocysteinemia induced by recreational nitrous oxide use. After treatment with vitamin B12 supplementation and intensive rehabilitative management, the patient progressively regained the ability to walk and her biological parameters gradually returned to normal. The pathophysiological mechanisms related to a decrease in vitamin B12 activity are the reduction of products needed for synthesis of deoxyribonucleic acid, carbohydrate or fatty acids, and the increase of hyperhomocysteinemia. Other mechanisms involving a direct action of N2O are also suspected. Conclusion This case report brings elements to support our knowledge about pathological pathway, recovery and prognosis of recreational N2O abuse complications. The general and medical population should be aware to the serious consequences of this type of consumption.

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Section: Discussionmentioning

confidence: 99%

Nitrous oxide-induced polyneuropathy, pancytopenia and pulmonary embolism: a case report

Parein,

Bollens

2023

J Med Case Reports

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Targeting the sulfur-containing amino acid pathway in leukemia

Chen,

Jin,

Chang

et al. 2024

Amino Acids

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Abstractsulfur-containing amino acids have been reported to patriciate in gene regulation, DNA methylation, protein synthesis and other physiological or pathological processes. In recent years, metabolism-related molecules of sulfur-containing amino acids affecting the occurrence, development and treatment of tumors have been implicated in various disorders, especially in leukemia. Here, we summarize current knowledge on the sulfur-containing amino acid metabolism pathway in leukemia and examine ongoing efforts to target this pathway, including treatment strategies targeting (a) sulfur-containing amino acids, (b) metabolites of sulfur-containing amino acids, and (c) enzymes and cofactors related to sulfur-containing amino acid metabolism in leukemia. Future leukemia therapy will likely involve innovative strategies targeting the sulfur-containing amino acid metabolism pathway.

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Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published between 1962 and 2022

Wirthensohn,

Wehrli,

Ljungblad

et al. 2023

Nutrients

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Pooled data from published reports on infants with clinically diagnosed vitamin B12 (B12) deficiency were analyzed with the purpose of describing the presentation, diagnostic approaches, and risk factors for the condition to inform prevention strategies. An electronic (PubMed database) and manual literature search following the PRISMA approach was conducted (preregistration with the Open Science Framework, accessed on 15 February 2023). Data were described and analyzed using correlation analyses, Chi-square tests, ANOVAs, and regression analyses, and 102 publications (292 cases) were analyzed. The mean age at first symptoms (anemia, various neurological symptoms) was four months; the mean time to diagnosis was 2.6 months. Maternal B12 at diagnosis, exclusive breastfeeding, and a maternal diet low in B12 predicted infant B12, methylmalonic acid, and total homocysteine. Infant B12 deficiency is still not easily diagnosed. Methylmalonic acid and total homocysteine are useful diagnostic parameters in addition to B12 levels. Since maternal B12 status predicts infant B12 status, it would probably be advantageous to target women in early pregnancy or even preconceptionally to prevent infant B12 deficiency, rather than to rely on newborn screening that often does not reliably identify high-risk children.

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Vitamin B12 Deficiency Resembling Acute Leukemia: A Case Report

Cited by 3 publications

References 8 publications

Nitrous oxide-induced polyneuropathy, pancytopenia and pulmonary embolism: a case report

Nitrous oxide-induced polyneuropathy, pancytopenia and pulmonary embolism: a case report

Targeting the sulfur-containing amino acid pathway in leukemia

Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published between 1962 and 2022

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