Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation
Nitrous oxide (N2O) is widely used as an anesthetic or an analgesic. N2O prolonged and recurrent administration is known to affect vitamin B12 metabolism with subsequent clinical consequences. We report herein the case of a 13-year-old girl with sickle cell disease exhibiting severe neurological and...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-06-01
|
| Series: | Molecular Genetics and Metabolism Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214426920300252 |
| _version_ | 1818318753335607296 |
|---|---|
| author | Camille Desprairies Apolline Imbard Bérengère Koehl Mathie Lorrot Jean Gaschignard Julie Sommet Samia Pichard Laurent Holvoet Albert Faye Malika Benkerrou Jean-François Benoist Manuel Schiff |
| author_facet | Camille Desprairies Apolline Imbard Bérengère Koehl Mathie Lorrot Jean Gaschignard Julie Sommet Samia Pichard Laurent Holvoet Albert Faye Malika Benkerrou Jean-François Benoist Manuel Schiff |
| author_sort | Camille Desprairies |
| collection | DOAJ |
| description | Nitrous oxide (N2O) is widely used as an anesthetic or an analgesic. N2O prolonged and recurrent administration is known to affect vitamin B12 metabolism with subsequent clinical consequences. We report herein the case of a 13-year-old girl with sickle cell disease exhibiting severe neurological and biochemical signs of functional vitamin B12 deficiency due to prolonged and repeated exposure to N2O. This was an incentive to prospectively investigate functional vitamin B12 deficiency in patients affected by sickle cell disease regularly exposed to N2O. We measured plasma concentrations of vitamin B12, total homocysteine, methionine and methylmalonic acid in 39 patients with sickle cell disease between 2015 and 2016. No patients developed neurological symptoms related to N2O administration but 19 patients (49%) had biochemical abnormalities suggesting mildly disturbed vitamin B12 metabolism e.g. decreased B12 vitamin, hypomethioninemia, or slightly increased methylmalonic acid or homocysteine. The clinical case highlight the potential severe deleterious effects of N2O over exposure on B12 vitamin metabolism in particular in patients affected with sickle cell disease. Conversely, when used without excess even repeatedly, there seem to be no overt clinically relevant abnormalities in vitamin B12 metabolism as observed on the cohort of 39 sickle cell disease affected patients. |
| first_indexed | 2024-12-13T09:58:14Z |
| format | Article |
| id | doaj.art-e6346a71e720453698e0e6b3b58211ac |
| institution | Directory Open Access Journal |
| issn | 2214-4269 |
| language | English |
| last_indexed | 2024-12-13T09:58:14Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Molecular Genetics and Metabolism Reports |
| spelling | doaj.art-e6346a71e720453698e0e6b3b58211ac2022-12-21T23:51:44ZengElsevierMolecular Genetics and Metabolism Reports2214-42692020-06-0123Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situationCamille Desprairies0Apolline Imbard1Bérengère Koehl2Mathie Lorrot3Jean Gaschignard4Julie Sommet5Samia Pichard6Laurent Holvoet7Albert Faye8Malika Benkerrou9Jean-François Benoist10Manuel Schiff11Reference Centre for Inborn Errors of Metabolism, Robert-Debré University Hospital, APHP, Paris 75019, FranceBiochemistry Laboratory Robert-Debré University Hospital, APHP, Paris 75019, France; LYPSIS2, Université Paris-Saclay, Chatenay-Malabry, FranceDepartment of Paediatrics, Robert-Debré University Hospital, APHP, Paris 75019, France; University of Paris, Paris-Diderot medical school, FranceDepartment of Paediatrics, Robert-Debré University Hospital, APHP, Paris 75019, FranceDepartment of Paediatrics, Robert-Debré University Hospital, APHP, Paris 75019, FranceDepartment of Paediatrics, Robert-Debré University Hospital, APHP, Paris 75019, FranceReference Centre for Inborn Errors of Metabolism, Robert-Debré University Hospital, APHP, Paris 75019, FranceDepartment of Child Haematology, Robert-Debré University Hospital, APHP, Paris 75019, FranceDepartment of Paediatrics, Robert-Debré University Hospital, APHP, Paris 75019, France; University of Paris, Paris-Diderot medical school, France; INSERM U1123, FranceDepartment of Child Haematology, Robert-Debré University Hospital, APHP, Paris 75019, FranceBiochemistry Laboratory Robert-Debré University Hospital, APHP, Paris 75019, France; LYPSIS2, Université Paris-Saclay, Chatenay-Malabry, FranceReference Centre for Inborn Errors of Metabolism, Robert-Debré University Hospital, APHP, Paris 75019, France; Reference Centre for Inborn Errors of Metabolism, Necker University Hospital, APHP, Paris, France; INSERM U1163, Imagine Institute, France; University of Paris, Paris-Descartes medical school, France; Corresponding author at: Reference Centre for Inborn Errors of Metabolism, Robert-Debré University Hospital, APHP, Paris 75019, France.Nitrous oxide (N2O) is widely used as an anesthetic or an analgesic. N2O prolonged and recurrent administration is known to affect vitamin B12 metabolism with subsequent clinical consequences. We report herein the case of a 13-year-old girl with sickle cell disease exhibiting severe neurological and biochemical signs of functional vitamin B12 deficiency due to prolonged and repeated exposure to N2O. This was an incentive to prospectively investigate functional vitamin B12 deficiency in patients affected by sickle cell disease regularly exposed to N2O. We measured plasma concentrations of vitamin B12, total homocysteine, methionine and methylmalonic acid in 39 patients with sickle cell disease between 2015 and 2016. No patients developed neurological symptoms related to N2O administration but 19 patients (49%) had biochemical abnormalities suggesting mildly disturbed vitamin B12 metabolism e.g. decreased B12 vitamin, hypomethioninemia, or slightly increased methylmalonic acid or homocysteine. The clinical case highlight the potential severe deleterious effects of N2O over exposure on B12 vitamin metabolism in particular in patients affected with sickle cell disease. Conversely, when used without excess even repeatedly, there seem to be no overt clinically relevant abnormalities in vitamin B12 metabolism as observed on the cohort of 39 sickle cell disease affected patients.http://www.sciencedirect.com/science/article/pii/S2214426920300252Nitrous oxideVitamin B12Sickle cell diseaseHyperhomocysteinemia |
| spellingShingle | Camille Desprairies Apolline Imbard Bérengère Koehl Mathie Lorrot Jean Gaschignard Julie Sommet Samia Pichard Laurent Holvoet Albert Faye Malika Benkerrou Jean-François Benoist Manuel Schiff Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation Molecular Genetics and Metabolism Reports Nitrous oxide Vitamin B12 Sickle cell disease Hyperhomocysteinemia |
| title | Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation |
| title_full | Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation |
| title_fullStr | Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation |
| title_full_unstemmed | Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation |
| title_short | Nitrous oxide and vitamin B12 in sickle cell disease: Not a laughing situation |
| title_sort | nitrous oxide and vitamin b12 in sickle cell disease not a laughing situation |
| topic | Nitrous oxide Vitamin B12 Sickle cell disease Hyperhomocysteinemia |
| url | http://www.sciencedirect.com/science/article/pii/S2214426920300252 |
| work_keys_str_mv | AT camilledesprairies nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT apollineimbard nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT berengerekoehl nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT mathielorrot nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT jeangaschignard nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT juliesommet nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT samiapichard nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT laurentholvoet nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT albertfaye nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT malikabenkerrou nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT jeanfrancoisbenoist nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation AT manuelschiff nitrousoxideandvitaminb12insicklecelldiseasenotalaughingsituation |