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Therapeutic Response to Sublingual Methylcobalamin in Children With Vitamin B12 Deficiency Anemia

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Abstract

Objective

To evaluate the efficacy and safety of sublingual methylcobalamin for the treatment of vitamin B12 deficiency anemia in children.

Methods

A single arm intervention study was conducted between November, 2020 and April, 2022 in children aged 1–12 years with vitamin B12 deficiency anemia. Children aged 1–6 years received a tablet of methylcobalamin (1500 mcg) by sublingual route every alternate day (three doses) while those aged 7–12 years received five such doses. Thereafter, one such sublingual tablet was given weekly and all participants were followed-up for 6 weeks.

Results

37 children with a mean (SD) age of 8.2 (4.1) years were treated and followed-up. On day 10, no child needed rescue therapy with parenteral methylcobalamin. After 6 weeks, the mean (SD) serum cobalamin increased from 123.3 (35.5) pg/mL to 507.3 (274.2) pg/mL (P<0.001), plasma homocysteine decreased from 48.9 (17.8) µmol/L to 16.3 (8.5) µmol/L (P<0.001), the mean (SD) hemoglobin increased by 2.3 (1.1) g/dL (P<0.001), and MCV decreased by 12.9 (6.8) fL (P<0.001). 67.6% children persisted to have anemia, albeit majority of them had mild or moderate anemia. There were no unsolicited side-effects reported.

Conclusion

Sublingual methylcobalamin is effective for the treatment of vitamin B12 deficiency anemia in children; although, the duration of treatment needs to be longer than six weeks.

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Funding

Funding: Intramural Research Grant

Author information

Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences & GTB Hospital, Delhi, India

    Chahat Saxena, Sweta Kumari, Pooja Dewan & Sunil Gomber

  2. Department of Neurochemistry, Institute of Human Behaviour and Allied Sciences, Delhi, India

    Rachna Agarwal

  3. Department of Neuropsychopharmacology, Institute of Human Behaviour and Allied Sciences, Delhi, India

    Sangeeta Sharma

  4. Department of Pediatric Hematology Oncology, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India

    Nita Radhakrishnan & Manideepa Maji

Authors
  1. Chahat Saxena
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  2. Sweta Kumari
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  3. Pooja Dewan
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  4. Sunil Gomber
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  5. Rachna Agarwal
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  6. Sangeeta Sharma
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  7. Nita Radhakrishnan
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  8. Manideepa Maji
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Contributions

Contributors: CS: data collection, data analysis and draft preparation; SK: data analysis, draft preparation and revised the manuscript; PD: conceptualized the research, supervised the work, analyzed the data and gave critical inputs; SG: supervision of work, data analysis and critical inputs; RA, SS: laboratory work, data analysis and critical inputs; NR, MM: data collection, analysis and critical inputs. All authors approved final manuscript and are accountable.

Corresponding author

Correspondence to Pooja Dewan.

Ethics declarations

Ethics clearance: Institutional Ethics Committee for Human Research, UCMS; No. IEC-HR/2020/PG/46/64-R1; IEC-HR/2021/51/6. IEC. Post Graduate Institute of Child Health, Noida; No. 2021-03-IM-14 datedAug 14, 2021.

Competing interests: None stated.

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Saxena, C., Kumari, S., Dewan, P. et al. Therapeutic Response to Sublingual Methylcobalamin in Children With Vitamin B12 Deficiency Anemia. Indian Pediatr 60, 913–916 (2023). https://doi.org/10.1007/s13312-023-3035-6

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  • DOI: https://doi.org/10.1007/s13312-023-3035-6

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