- Systematic Review of Vitamin B12 Regimen for Patient with Subacute Combined Degeneration of the Spinal Cord Following Nitrous Oxide Abuse
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Jin Seok Chung, Min Hong Choa, Sung Phil Chung, In Cheol Park
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J Korean Soc Clin Toxicol. 2019;17(2):79-85. Published online December 31, 2019
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DOI: https://doi.org/10.22537/jksct.2019.17.2.79
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Abstract
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- Purpose: The purpose of this study is to evaluate the effectiveness of vitamin B12 treatment in subacute combined degeneration (SCD) caused by nitrous oxide (N2O) abuse. Methods: Relevant literature was accessed through PubMed, EMBASE, Scopus, and KoreaMed. All the literature that was relevant to human use of vitamin B12 treatment for SCD caused by N2O abuse was included. Case reports were excluded if the treatment regimens were not precisely described. The literature search was conducted by two investigators during September 2019 for the final publication period. The languages of the publications were restricted to English and Korean. Results: Twenty-three published articles that contained 24 cases were included. Sixteen cases among them were treated with intramuscular vitamin B12 of 1 mg/day and the rest received different doses or routes. Although most cases described significant clinical improvements, one case showed no beneficial effect due to the patient's noncooperation. Another case showed adverse events, including spinal myoclonus, following vitamin B12 therapy. Conclusion: Vitamin B12 has been broadly used for the treatment of SCD caused by N2O abuse. However, most of the relevant studies were case reports that reported various regimens of vitamin B12 administration. Further studies are needed to establish a standard regimen of vitamin B12 because the incidence of N2O abuse may increase in South Korea.
- Fomepizole for Ethylene Glycol or Methanol Poisoning in Children
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Ha Na Min, Yoon Jung Hwang, Dong Ryul Ko, Young Seon Joo, Tae Young Kong, Min Hong Choa, In Cheol Park, Sung Phil Chung
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J Korean Soc Clin Toxicol. 2017;15(2):79-85. Published online December 31, 2017
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DOI: https://doi.org/10.22537/jksct.2017.15.2.79
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Abstract
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- Purpose: The purpose of this study is to evaluate the effectiveness and adverse effect of fomepizole in the management of acute ethylene glycol or methanol poisoning in children. Methods: Databases such as PubMed, Embase, Cochrane library, and KoreaMed were searched using terms related to fomepizole, ethylene glycol, methanol and pediatric. All studies, regardless of study design, reporting effectiveness or safety endpoints in children were included. Reference citations from identified publications were reviewed. Only reports written in English or Korean languages were included. The reference search was performed by two authors. Results: Twenty-two relevant literatures were finally included. They were one narrative review, 4 retrospective case series, and 17 case reports (19 cases). Case reports were classified as 5 fomepizole only, 8 fomepizole with other therapies, and 6 no fomepizole. All patients from the literatures were fully recovered without long term sequelae. Adverse effects of fomepizole were reported including anaphylaxis, thrombophlebitis and nystagmus. Conclusion: There are insufficient literatures regarding fomepizole treatment in children with ethylene glycol or methanol poisoning. The benefits or harms are not clearly established based on the clinical evidences. More prospective comparative studies are required in the future.
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