Subacute combined degeneration of the spinal cord in a patient with nitrous oxide use and autoimmune atrophic gastritis.
Male
Adolescent
Young Adult
Humans
Subacute Combined Degeneration
/ drug therapy
Nitrous Oxide
/ adverse effects
Gastritis, Atrophic
/ complications
Spinal Cord
/ diagnostic imaging
Vitamin B 12 Deficiency
/ chemically induced
Vitamin B 12
/ therapeutic use
Atrophy
/ pathology
Gastritis
/ chemically induced
Neurology
Neuromuscular disease
Psychiatry (drugs and medicines)
Spinal cord
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
30 Nov 2023
30 Nov 2023
Historique:
medline:
4
12
2023
pubmed:
1
12
2023
entrez:
30
11
2023
Statut:
epublish
Résumé
Nitrous oxide is among the most common drugs used by adolescents and young adults, and its neuropsychiatric sequelae are severe but reversible with timely treatment. The causal mechanism relates to impaired metabolism of vitamin B12, which is necessary for the development and maintenance of the myelin sheath. Individuals most susceptible to neuropsychiatric manifestations are those with a secondary cause of vitamin B12 deficiency, including nutritional deficiency and impaired absorption, or an alternative cause of impaired metaboclism. We describe the case of a man in his thirties who developed subacute combined degeneration of the spinal cord and polyneuropathy in the setting of recreational nitrous oxide use and autoimmune atrophic gastritis. Our case highlights clinical pearls for diagnosis and treatment, differential diagnosis, common concomitant aetiologies and the importance of screening for substance use disorder and psychiatric comorbidities.
Identifiants
pubmed: 38035681
pii: 16/11/e254727
doi: 10.1136/bcr-2023-254727
pmc: PMC10689362
pii:
doi:
Substances chimiques
Nitrous Oxide
K50XQU1029
Vitamin B 12
P6YC3EG204
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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