Aydin Sultan, Islamoglu Suheyla Ceren, Oz Ayse
Department of Pediatric Hematology and Oncology, Antalya Training and Research Hospital, 07100 Antalya, Turkey.
Department of Pediatrics, Antalya Training and Research Hospital, 07100 Antalya, Turkey.
Children (Basel). 2025 Mar 30;12(4):442. doi: 10.3390/children12040442.
Effective and timely treatment of vitamin B12 deficiency in childhood is crucial because it can lead to serious issues, including delayed growth and neuromotor development. Available treatment options include oral, intramuscular, and sublingual administration.
This study investigated the efficacy of a new dosing protocol for sublingual methylcobalamin.
In total, 312 patients with vitamin B12 deficiency (serum level < 250 ng/L) were divided into two groups based on their treatment type: intramuscular cyanocobalamin (Group 1) and sublingual methylcobalamin (Group 2). Group 1 included 29 (9.3%) patients, and Group 2 included 283 (90.7%) patients, with 56 (18%) patients in Group 2 undergoing treatment for childhood cancer. The sublingual methylcobalamin protocol consisted of 1 puff (500 μg) daily for children under 8 years of age and 2 puffs (1000 μg) daily for those 8 years and older, administered for 1.5 months and then three times weekly for an additional 1.5 months.
The mean ages in Groups 1 and 2 were 10.07 ± 6.05 years (range, 1-17 years) and 7.43 ± 5.86 years (range, 0.1-17 years), respectively. The female/male ratio was 19/10 in Group 1 and 145/138 in Group 2. The most common diagnoses were anemia (72, 22.9%), cancer (56, 18.0%), and hemangioma (40, 12.7%). The median serum levels of vitamin B12 in Group 1 were 177 ng/L before treatment, 447 ng/L after 1.5 months, and 321.5 ng/L after 3 months. In Group 2, the levels were 172 ng/L before treatment, 438 ng/L after 1.5 months, and 360 ng/L after 3 months. There were no significant between-group differences. Both groups showed a statistically significant increase in levels above 300 ng/L.
Sublingual methylcobalamin, a noninvasive treatment option, was as effective as intramuscular cyanocobalamin. This study is to compare the standard intramuscular protocol with a new dosing regimen for sublingual methylcobalamin. This study showed that it is also useful for children to hold the spray in their mouths for 1 min and avoid food intake for the next 15 min.
儿童维生素B12缺乏症的有效及时治疗至关重要，因为它会导致严重问题，包括生长发育迟缓和神经运动发育迟缓。可用的治疗方法包括口服、肌肉注射和舌下给药。
本研究调查了一种新的舌下甲钴胺给药方案的疗效。
总共312例维生素B12缺乏症患者（血清水平<250 ng/L）根据治疗类型分为两组：肌肉注射氰钴胺（第1组）和舌下甲钴胺（第2组）。第1组包括29例（9.3%）患者，第2组包括283例（90.7%）患者，第2组中有56例（18%）患者正在接受儿童癌症治疗。舌下甲钴胺方案为8岁以下儿童每日1喷（500μg），8岁及以上儿童每日2喷（1000μg），给药1.5个月，然后每周三次，再给药1.5个月。
第1组和第2组的平均年龄分别为10.07±6.05岁（范围1-17岁）和7.43±5.86岁（范围0.1-17岁）。第1组的男女比例为19/10，第2组为145/138。最常见的诊断是贫血（72例，22.9%）、癌症（56例，18.0%）和血管瘤（40例，12.7%）。第1组治疗前维生素B12的血清中位数水平为177 ng/L，1.5个月后为447 ng/L，3个月后为321.5 ng/L。第2组治疗前水平为172 ng/L，1.5个月后为438 ng/L，3个月后为360 ng/L。两组之间无显著差异。两组维生素B12水平均显著升高至300 ng/L以上。
舌下甲钴胺作为一种非侵入性治疗选择，与肌肉注射氰钴胺一样有效。本研究旨在将标准肌肉注射方案与新的舌下甲钴胺给药方案进行比较。本研究表明，让儿童将喷雾剂含在口中1分钟，并在接下来的15分钟内避免进食也是有用的。
