Intranasal treatment of vitamin B12 deficiency in children - European Journal of Pediatrics

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.

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Authors and Affiliations

1. Department of Paediatrics, St. Antonius Hospital, PB 2500, 3430 EM, Nieuwegein, The Netherlands

   G. Frederiek Estourgie-van Burk

2. Department of Clinical Pharmacy, Erasmus Medical Centre, Rotterdam, The Netherlands

   P. Hugo M. van der Kuy

3. Department of Paediatric Gastroenterology and Nutrition, Amsterdam University Medical Centres, Location VU Medical Centre, Amsterdam, The Netherlands

   Tim G. de Meij & C. M. Frank Kneepkens

4. Department of Paediatric Gastroenterology and Nutrition, Amsterdam University Medical Centres, Location Academic Medical Centre/Emma Children’s Hospital, Amsterdam, The Netherlands

   Marc A. Benninga

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.

Corresponding author

Correspondence to G. Frederiek Estourgie-van Burk.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all participants.

Communicated by Mario Bianchetti

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