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The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience

Yıl 2022, Cilt: 3 Sayı: 3, 259 - 263, 30.11.2022

Hatice Mine Çakmak Yaşar Bildirici

https://doi.org/10.48176/esmj.2022.83

Öz

Introduction: Vitamin B12 deficiency is essential to treat because of hematologic and neurologic results. Sublingual methylcobalamin spray leads to easy, safe, and cost-effective treatment. However, studies reveal the different duration of treatment; age-specific dose is not precise. Here, we aimed to investigate the efficacy, dose adjustment, and durability of vitamin-B12 spray. Methods: This retrospective study includes seventeen children (3 months-17 years) diagnosed with nutritional Vitamin-B12 deficiency between January 2020- January 2021. The methylcobalamin doses were 500 mcg (<1 year of age) and 1000 mcg (≥1 year of age) every day for the first week and every other day for seven weeks. In addition, serum Vitamin B12 and hemoglobin levels were studied at diagnosis and second, sixth, and twelfth months of treatment. Finally, we compared the beginning hemoglobin and Vitamin-B12 levels with the second month's values. Results: After two months of sublingual methylcobalamin treatment, the Vitamin B12 significantly increased (p=0.008) and kept normal ranges for twelve months. Hemoglobin levels tended to rise in two months, but the difference was not statistically significant (p=0.22). Conclusion: There is no consensus on the sublingual methylcobalamin dose and treatment schedule. However, we suggest that a 500 mcg dose of methylcobalamin for <1 year of age and a 1000 mcg dose for ≥ 1 year with two months treatment period is appropriate and safe for nutritional Vitamin B12 deficiency.

Anahtar Kelimeler

Child Vitamin B12 deficiency Vitamin B12

Kaynakça

  • 1. Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496-513. https://doi.org/10.1111/bjh.12959.
  • 2. Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood. 2017;129(19):2603-2611. https://doi.org/10.1182/blood-2016-10-569186.
  • 3. Hannibal L, Lysne V, Bjørke-Monsen AL, Behringer S, Grünert SC, Spiekerkoetter U, et al. Biomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency. Front Mol Biosci. 2016;3:27. https://doi.org/10.3389/fmolb.2016.00027.
  • 4. Sobczyńska-Malefora A, Delvin E, McCaddon A, Ahmadi KR, Harrington DJ. Vitamin B12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency - clinical and laboratory pitfalls. Crit Rev Clin Lab Sci. 2021;58(6):399-429. https://doi.org/10.1080/10408363.2021.1885339.
  • 5. Chan CQ, Low LL, Lee KH. Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia. Front Med (Lausanne). 2016;3:38. https://doi.org/10.3389/fmed.2016.00038
  • 6. Thakkar K, Billa G. Treatment of vitamin B12 deficiency-methylcobalamin? Cyanocobalamin? Hydroxocobalamin?-clearing the confusion. Eur J Clin Nutr 2015;69(1): 1-2. https://doi.org/10.1038/ejcn.2014.
  • 7. Vidal-Alaball J, Butler CC, Cannings-John R, Goringe A, Hood K, McCaddon A, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2005;(3): CD004655. Update in: Cochrane Database Syst Rev. 2018;3:CD004655. https://doi.org/10.1002/14651858.
  • 8. Bensky MJ, Ayalon-Dangur I, Ayalon-Dangur R. Naamany E, Gafter-Gvili A, Korcn G. Comparison of sublingual vs. intramuscular administration of vitamin B 12 for the treatment of patients with vitamin B 12 defıciency. Drug DelivTransı Res. 2019:9(3):625-630. https://doi.org/10.1007/s13346-018-00613-y.
  • 9. Bahadir A1, Reis PG, Erduran E. Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency. J Paediatr Child Health. 2014;50(9):721–725. https://doi.org/10.1111/jpc.12652.
  • 10. Verma D, Chandra J, Kumar P, Shukla S, Sengupta S. Efficacy of oral Methylcobalamin in treatment of vitamin B 12 deficiency anemia in children. Pediatr Blood Cancer. 2017;64(12). https://doi.org/10.1002/pbc.26698.
  • 11. Kartal TA, Mutlu ÇZ. Comparison of Sublingual and Intramuscular Administration Of Vitamin B 12 for the Treatment of Vitamin B 12 Deficiency in Children. Rev Invest Clin. 2020;72(6):380-385. https://doi.org/10.24875/RIC.20000208
  • 12. Kiliç BO, Kiliç S, Eroğlu EŞ, Gül E, Apak FBB. Sublingual methylcobalamin treatment is as effective as intramuscular and peroral cyanocobalamin in children age 0–3 years, Hematology. 2021; 26:1013-1017. https://doi.org/10.1080/16078454.
  • 13. Varkal MA, Karabocuoglu M. Efficiency of the sublingual route in treating B I 2 deficiency in infants. Int J Vitam Nutr Res. 2021 Aug 25. https://doi.org/10.1024/0300-9831/a000724

Dilaltı metilkobalamin spreyin çocuklardaki etkinliği, dozu ve veriliş sıklığı: tek merkez deneyimi

Yıl 2022, Cilt: 3 Sayı: 3, 259 - 263, 30.11.2022

Hatice Mine Çakmak Yaşar Bildirici

https://doi.org/10.48176/esmj.2022.83

Öz

Giriş: Vitamin B12 eksikliğinin tedavisi, hematolojik ve nörolojik sonuçları nedeniyle çok önemlidir. Dilaltı metilkobalamin, kolay uygulama, güvenilir ve ucuz bir tedavidir. Çocuklarda, değişik doz, uygulama ve tedavi süreleri bildirilmiştir. Bu çalışmanın amacı, metil kobalaminin etkinliğini, doz ayarlamasını ve etkinliğini devam ettirebilirliğini araştırmaktır. Yöntemler: Bu retrospektif çalışmaya, Ocak 2020-Ocak 2021 tarihleri arasında bir çocuk hematoloji-onkoloji polikliniğinde Vitamin B12 eksikliği tanısı almış on yedi hasta (3 ay-17 yaş) dahil edildi. Bir yaş altına 500 mikrogram, 1 yaş ve üzerine 1000 mikrogram dilaltı metilkobalamin sprey, ilk hafta her gün, sonraki yedi hafta iki günde bir uygulandı. Serum vitamin B12 ve hemoglobin değerleri tanıda, tedavinin ikinci, altıncı ve onikinci aylarında alındı. Tanıdaki ve ikinci aydaki Vitamin B12 ve hemoglobin değerleri karşılaştırıldı. Bulgular: İki ay dilatı metilkobalamin tedavisi sonrasında, vitamin B12 düzeyinde anlamlı artış gözlendi (p=0,008), oniki aylık izlemde serum vitamin B12 düzeyi normal değerlerini korudu. Tedavinin ikinci ayında, hemoglobin değerleri yükselme eğiliminde idi. Ancak, bu fark istatistiksel anlamlı bulunmadı (p=0.22). Sonuç: Çocuklarda Vitamin B12 eksikliği tedavisinde metilkobalaminin dozu ve tedavi süresi konusunda fikir birliği bulunmamaktadır. Biz bu çalışmada, nutrisyonel B12 eksikliği bulunan çocuklarda 1 yaş altı çocuklarda 500 mikrogram, 1 yaş ve üzeri için 1000 mikrogramın iki aylık tedavi ile etkin ve güvenilir olduğunu bildirmekteyiz.

Anahtar Kelimeler

Çocuk Vitamin B12 eksikliği Vitamin B12

Kaynakça

  • 1. Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166(4):496-513. https://doi.org/10.1111/bjh.12959.
  • 2. Green R. Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood. 2017;129(19):2603-2611. https://doi.org/10.1182/blood-2016-10-569186.
  • 3. Hannibal L, Lysne V, Bjørke-Monsen AL, Behringer S, Grünert SC, Spiekerkoetter U, et al. Biomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency. Front Mol Biosci. 2016;3:27. https://doi.org/10.3389/fmolb.2016.00027.
  • 4. Sobczyńska-Malefora A, Delvin E, McCaddon A, Ahmadi KR, Harrington DJ. Vitamin B12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency - clinical and laboratory pitfalls. Crit Rev Clin Lab Sci. 2021;58(6):399-429. https://doi.org/10.1080/10408363.2021.1885339.
  • 5. Chan CQ, Low LL, Lee KH. Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia. Front Med (Lausanne). 2016;3:38. https://doi.org/10.3389/fmed.2016.00038
  • 6. Thakkar K, Billa G. Treatment of vitamin B12 deficiency-methylcobalamin? Cyanocobalamin? Hydroxocobalamin?-clearing the confusion. Eur J Clin Nutr 2015;69(1): 1-2. https://doi.org/10.1038/ejcn.2014.
  • 7. Vidal-Alaball J, Butler CC, Cannings-John R, Goringe A, Hood K, McCaddon A, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2005;(3): CD004655. Update in: Cochrane Database Syst Rev. 2018;3:CD004655. https://doi.org/10.1002/14651858.
  • 8. Bensky MJ, Ayalon-Dangur I, Ayalon-Dangur R. Naamany E, Gafter-Gvili A, Korcn G. Comparison of sublingual vs. intramuscular administration of vitamin B 12 for the treatment of patients with vitamin B 12 defıciency. Drug DelivTransı Res. 2019:9(3):625-630. https://doi.org/10.1007/s13346-018-00613-y.
  • 9. Bahadir A1, Reis PG, Erduran E. Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency. J Paediatr Child Health. 2014;50(9):721–725. https://doi.org/10.1111/jpc.12652.
  • 10. Verma D, Chandra J, Kumar P, Shukla S, Sengupta S. Efficacy of oral Methylcobalamin in treatment of vitamin B 12 deficiency anemia in children. Pediatr Blood Cancer. 2017;64(12). https://doi.org/10.1002/pbc.26698.
  • 11. Kartal TA, Mutlu ÇZ. Comparison of Sublingual and Intramuscular Administration Of Vitamin B 12 for the Treatment of Vitamin B 12 Deficiency in Children. Rev Invest Clin. 2020;72(6):380-385. https://doi.org/10.24875/RIC.20000208
  • 12. Kiliç BO, Kiliç S, Eroğlu EŞ, Gül E, Apak FBB. Sublingual methylcobalamin treatment is as effective as intramuscular and peroral cyanocobalamin in children age 0–3 years, Hematology. 2021; 26:1013-1017. https://doi.org/10.1080/16078454.
  • 13. Varkal MA, Karabocuoglu M. Efficiency of the sublingual route in treating B I 2 deficiency in infants. Int J Vitam Nutr Res. 2021 Aug 25. https://doi.org/10.1024/0300-9831/a000724
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Hatice Mine Çakmak 0000-0003-3730-0982

Yaşar Bildirici 0000-0002-4784-7810

Yayımlanma Tarihi 30 Kasım 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 3 Sayı: 3

Kaynak Göster

APA Çakmak, H. M., & Bildirici, Y. (2022). The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience. Eskisehir Medical Journal, 3(3), 259-263. https://doi.org/10.48176/esmj.2022.83
AMA Çakmak HM, Bildirici Y. The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience. Eskisehir Med J. Kasım 2022;3(3):259-263. doi:10.48176/esmj.2022.83
Chicago Çakmak, Hatice Mine, ve Yaşar Bildirici. “The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience”. Eskisehir Medical Journal 3, sy. 3 (Kasım 2022): 259-63. https://doi.org/10.48176/esmj.2022.83.
EndNote Çakmak HM, Bildirici Y (01 Kasım 2022) The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience. Eskisehir Medical Journal 3 3 259–263.
IEEE H. M. Çakmak ve Y. Bildirici, “The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience”, Eskisehir Med J, c. 3, sy. 3, ss. 259–263, 2022, doi: 10.48176/esmj.2022.83.
ISNAD Çakmak, Hatice Mine - Bildirici, Yaşar. “The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience”. Eskisehir Medical Journal 3/3 (Kasım 2022), 259-263. https://doi.org/10.48176/esmj.2022.83.
JAMA Çakmak HM, Bildirici Y. The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience. Eskisehir Med J. 2022;3:259–263.
MLA Çakmak, Hatice Mine ve Yaşar Bildirici. “The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience”. Eskisehir Medical Journal, c. 3, sy. 3, 2022, ss. 259-63, doi:10.48176/esmj.2022.83.
Vancouver Çakmak HM, Bildirici Y. The Efficacy, Dose and Interval Of Sublingual Methylcobalamin Spray in Children: A Single-Center Experience. Eskisehir Med J. 2022;3(3):259-63.
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