{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:58:13Z","timestamp":1789696693988,"version":"4.0.1"},"reference-count":18,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2024,2,15]]},"abstract":"<jats:p>The recreational use of nitrous oxide as laughing gas becomes a real public health issue among adolescents and young adults. Chronic use is deleterious and can lead to severe neurological disorders. Nitrous oxide inactivates vitamin B12, and the functional defect of vitamin B12 plays a major role in the pathogenesis of nitrous oxide-related neurological disorders. Here we report the case of a 22-year-old woman who came to the hospital after an unexplained loss of consciousness. She exhibited typical features of vitamin B12 or folate deficiency such as macrocytic anemia and hypersegmented neutrophils. However, serum concentrations of folate and vitamin B12 were normal. In contrast, circulating concentrations of total homocysteine and methylmalonic acid were significantly increased. These results clearly indicated a defect in vitamin B12 functions. The reason for this defect was clarified when she revealed that she had been consuming nitrous oxide recreationally for over a year. The present case points out the challenges in diagnosing vitamin B12 deficiency in the context of nitrous oxide abuse due to normal concentrations of total serum vitamin B12 in a significant proportion of cases. The medical community should be aware of how difficult it can be to interpret B12 status in this specific population.<\/jats:p>","DOI":"10.11613\/bm.2024.010801","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T13:05:38Z","timestamp":1702991138000},"page":"117-123","source":"Crossref","is-referenced-by-count":7,"title":["A case of functional vitamin B12 deficiency after recreational nitrous oxide use"],"prefix":"10.11613","volume":"34","author":[{"given":"Damien","family":"Leleu","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry, Dijon University Hospital, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Denimal","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Dijon University Hospital, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"key20231219080530_r1","unstructured":"Drug misuse in England and Wales - Office for National Statistics. Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/crimeandjustice\/articles\/drugmisuseinenglandandwales\/yearendingjune2022. 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What do they have in common?","volume":"7","author":"Hoss","year":"2019","journal-title":"J Inborn Errors Metab Screen"},{"key":"key20231219080530_r15","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1007\/s00415-019-09600-w","article-title":"The sharp rise of neurological disorders associated with recreational nitrous oxide use in China: a single-center experience and a brief review of Chinese literature.","volume":"267","author":"Zheng","year":"2020","journal-title":"J Neurol"},{"key":"key20231219080530_r16","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.2402","article-title":"Nitrous oxide-related neurological disorders: clinical, laboratory, neuroimaging, and electrophysiological findings.","volume":"11","author":"Jiang","year":"2021","journal-title":"Brain Behav"},{"key":"key20231219080530_r17","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1111\/ene.15370","article-title":"Myeloneuropathy induced by recreational nitrous oxide use with variable exposure levels.","volume":"29","author":"Largeau","year":"2022","journal-title":"Eur J Neurol"},{"key":"key20231219080530_r18","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1007\/s00415-021-10748-7","article-title":"Neurological consequences of recreational nitrous oxide abuse during SARS-CoV-2 pandemic.","volume":"269","author":"Vollhardt","year":"2022","journal-title":"J Neurol"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/34\/1\/10.11613\/BM.2024.010801\/fullArticle","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T14:43:13Z","timestamp":1718203393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/34\/1\/10.11613\/BM.2024.010801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2024.010801","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,15]]}}}