title: [Intranasal cyanocobalamin; an effective and safe therapeutic alternative].
abstract: Vitamin B12 or cobalamin deficiency is a common nutritional disorder, in which the early recognition and treatment is critical since it is a reversible cause of bone marrow failure and demyelinating nervous system disease. Insufficient intake of vitamin along with anatomical or functional disorders of the stomach, pancreas and terminal ileum are the most frequent causes of the deficit. We present three cases of patients with cobalamin deficiency secondary to intestinal malabsorption after bariatric surgery, in relation to autoimmune process and inflammatory bowel disease mechanisms respectively, which conditioned a lack of response to treatment with high-dose oral cyanocobalamin. They also had contraindication to intramuscular administration of cyanocobalamin by the use of oral anticoagulants. In such patients, the use of an inhaled formulation cyanocobalamin provides an adequate absorption, normalizing serum cobalamin and without the existence of side effects.
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital General Universitario de Alicante. Alicante. España.. matildex@hotmail.com.
authors.forename: Matilde Bettina
authors.initials: MB
authors.lastname: Mijares Zamuner
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital General Universitario de Alicante. Alicante. España.. vlgonzalez81@gmail.com.
authors.forename: Víctor
authors.initials: V
authors.lastname: González
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital General Universitario de Alicante. Alicante. España.. angeluis1024@ono.com.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Abad
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital General Universitario de Alicante. Alicante. España.. perdiguero_mig@yahoo.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Perdiguero
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital General Universitario de Alicante. Alicante. España.. pico_ant@gva.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Picó
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy*; D014803:Vitamin B Complex / Q000008:administration & dosage*
chemical_list: D014803:Vitamin B Complex; D014805:Vitamin B 12