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Intranasal treatment of vitamin B12 deficiency in children

  • G. Frederiek Estourgie-van BurkEmail author
  • P. Hugo M. van der Kuy
  • Tim G. de Meij
  • Marc A. Benninga
  • C. M. Frank Kneepkens
Short Communication

Abstract

Vitamin B12 deficiency is traditionally treated with intramuscular injections of cobalamin, which are stressful events for children. In adults, studies have shown adequate absorption of intranasally administered vitamin B12. To date, data concerning efficacy of intranasal administration of vitamin B12 in children are lacking. We report on ten cases of children with vitamin B12 deficiency who were successfully treated with intranasal administration of a spray containing hydroxocobalamin. The mean baseline vitamin B12 concentration increased from 126.3 pmol/l (SD 55.4) to 1914.7 pmol/l (SD 1509.7). No side effects were reported.

Conclusion: In children, intranasal application of vitamin B12 seems a safe and effective alternative to intramuscular injections, leading to higher compliance and less burden to patients.

What is Known:

• Children with vitamin B12deficiency are traditionally treated with intramuscular cobalamin injections, which are costly and painful.

• Studies in adults showed that intranasal application of hydroxocobalamin leads to normalisation of vitamin B12levels.

What is New:

• The intranasal application of vitamin B12resulted in a substantial increase of the mean baseline vitamin B12levels without any side effect.

• These data encourage a systematic evaluation of intranasal treatment of vitamin B12deficiency in order to define safety, optimal dosage and administration frequency.

Keywords

Cobalamin deficiency Hydroxocobalamin Nasal spray Paediatric 

Abbreviations

MMA

Methylmalonic acid

Notes

Authors’ contributions

All authors contributed to the study conception and design. Acquisition of the data was performed by FE, TdM, MB and FK. FE, HvdK and FK were involved in data interpretation. The first draft of the manuscript was written by FE. FE and FK wrote the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all participants.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PaediatricsSt. Antonius HospitalNieuwegeinThe Netherlands
  2. 2.Department of Clinical PharmacyErasmus Medical CentreRotterdamThe Netherlands
  3. 3.Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centres, Location VU Medical CentreAmsterdamThe Netherlands
  4. 4.Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centres, Location Academic Medical Centre/Emma Children’s HospitalAmsterdamThe Netherlands

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