因滥用氧化亚氮“笑气弹”出现对钴胺素反应性精神病。
Nitrous oxide "whippit" abuse presenting with cobalamin responsive psychosis.
作者信息
Sethi Nitin K, Mullin Paul, Torgovnick Josh, Capasso Giuseppe
机构信息
Department of Neurology, Saint Vincent's Hospital and Medical Centers, New York, NY 10011, USA.
出版信息
J Med Toxicol. 2006 Jun;2(2):71-4. doi: 10.1007/BF03161175.
INTRODUCTION
Nitrous oxide is a commonly abused inhalant drug. It is known to precipitate vitamin B12 deficiency when used chronically and acutely, especially in people having marginal vitamin B12 reserve.
CASE REPORT
We are presenting a case of nitrous oxide "whippit" abuse in a thirty-three-year-old male with bizarre behavior and delusions. The patient had low normal levels of vitamin B12 (202 pg/ml), but he had markedly high methylmalonyl CoA (1078 nmol/L) and homocysteine (48.4 mcmol/L). Treatment with intramuscular cobalamin led to a resolution of his psychosis.
DISCUSSION
This case report highlights the need to consider vitamin B12 deficiency in patients who arrive at a hospital with psychiatric manifestations and who report having a history of nitrous oxide exposure or abuse in the recent or remote past. A review of the literature on the neuropsychological manifestations of vitamin B12 deficiency is provided.
引言
一氧化二氮是一种常见的滥用吸入性药物。已知长期和急性使用时，它会导致维生素B12缺乏，尤其是在维生素B12储备处于临界水平的人群中。
病例报告
我们报告一例33岁男性滥用一氧化二氮“笑气”的病例，该患者出现怪异行为和妄想。患者维生素B12水平略低于正常（202 pg/ml），但甲基丙二酸辅酶A（1078 nmol/L）和同型半胱氨酸（48.4 μmol/L）显著升高。肌肉注射钴胺素治疗后，他的精神病症状得到缓解。
讨论
本病例报告强调，对于因精神症状入院且近期或既往有一氧化二氮接触或滥用史的患者，有必要考虑维生素B12缺乏的情况。本文还对维生素B12缺乏的神经心理学表现相关文献进行了综述。
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