vitamin-b-12 and Dysgeusia

Anemia is the most common dose-limiting toxicity of olaparib. However, few studies have analyzed the clinical features of olaparib-induced anemia. This study investigated the clinical features of olaparib-induced anemia. Additionally, the role of folate or vitamin B12 in olaparib-induced anemia was examined. This retrospective case-control study included patients who received olaparib at Mie University Hospital between January 2018 and December 2020. Data were collected between initiation of olaparib and discontinuation of olaparib or till December 2021. We investigated the development of grade ≥ 3 anemia during olaparib administration for at least 1 year. We examined patients with grade ≥ 3 anemia considering the mean corpuscular volume (MCV), its association with gastrointestinal events and cumulative dose of carboplatin. For the sub-study analysis, data on patients treated with olaparib for ovarian or endometrial cancer were collected to evaluate the Common Terminology Criteria for Adverse Events (CTCAE) or monthly changes in folate or vitamin B12 levels from baseline to 3 months after olaparib initiation. These data were collected between initiation of olaparib and discontinuation of olaparib or till November 2022. Patients with no data on folic acid or vitamin B12 levels were excluded from the sub-study. In the main study, 40 patients were included. Eighteen patients (45%) developed grade ≥ 3 anemia, and all patients discontinued treatment (94%) or reduced olaparib dose (67%) after developing anemia. Among the patients with grade ≥ 3 anemia, 9 (50%) exhibited macrocytic anemia and 15 (83%) had previously received carboplatin. The incidence of grade ≥ 2 dysgeusia was significantly higher in patients with grade ≥ 3 anemia (P = .034). Moreover, the cumulative dose of previously administered carboplatin was higher in patients who had 3 episodes of anemia (P = .102). In sub-study, 12 had data on folic acid and vitamin B12 levels. Sub-study analysis showed that none fulfilled the criteria for deficiency of folate or vitamin B12, while 3 developed grade 3 anemia. This study revealed that olaparib-induced anemia frequently occurs as macrocytic and normocytic erythroblastic anemia without folate or vitamin B12 deficiencies. A high cumulative dose of previously administered carboplatin and dysgeusia may be associated with olaparib-induced anemia.

Topics: Anemia; Carboplatin; Case-Control Studies; Dysgeusia; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Atypical dysgeusia such as having the sensation of a sweet tooth is an uncommon clinical presentation in severe depression. First, we present the case of a 67 year-old-man admitted to the psychiatric ward for depression after a suicide attempt by drug ingestion. The patient manifested a sweet taste sensation in the upper and lower gums that increased with mood swings and notably with severe depressive symptoms. Blood tests showed an elevated serum creatinine level (115 μmol/L), a normocytic anemia (hemoglobin 6.5 mmol/L; MCV 96 fL) and a deficit in vitamin B12 (122.4 pmol/L). The patient received vitamin B12 supplementation and was treated with clomipramine, lithium, mirtazapine, modafinil, and olanzapine. He was discharged after improvement of his depressive symptoms and decrease in the sweet taste. On follow-up, the patient's dysgeusia had subsided. Second, we hypothesize that the atypical dysgeusia may have been induced by vitamin B12 deficiency and medical comorbidities, leading to deafferentation (development of erroneous mouth mucosae sensations felt by the patient). This could have been increased by depression. Dysgeusia in elederly patients with depression should be extensively investigated in order to elucidate somatic contributing factors but it may not resolve until improvement of the depressive symptoms.

Topics: Aged; Anemia; Depression; Dysgeusia; Humans; Male; Olanzapine; Vitamin B 12

Iron deficiency is frequent in haemodialysis (HD) patients with chronic kidney disease (CKD), and intravenous iron is an established therapy for these patients. This study assessed treatment routine, effectiveness, and safety of iron isomaltoside (IIM) 5% (Diafer®) in a HD cohort.. This prospective observational study included 198 HD patients converted from iron sucrose (IS) and treated with IIM according to product label and clinical routine. Data for IIM were compared to historic data for IS in 3-month intervals. The primary endpoint was to show non-inferiority for IIM versus IS in haemoglobin (Hb) maintenance.. Most patients (> 60%) followed a fixed low-dose iron treatment protocol. Three minutes were required for preparation and administration of IIM. Erythropoiesis-stimulating agent (ESA) was used in > 80% of patients during both IIM and IS phases. The maintenance of Hb was similar with both iron drugs; the mean Hb level was 11 g/dL, and the mean change of 0.3 g/dL (95% confidence interval: 0.1, 0.5) for IIM 0-3 months compared to IS demonstrated non-inferiority. Nine adverse drug reactions were reported in 2% of patients administered IIM. All patients had uneventful recoveries. The frequency of metallic taste was higher with IS compared to IIM (34% versus 0.5%, p < 0.0001).. IIM is effective and well tolerated by CKD patients on HD. IIM was non-inferior to IS in maintenance of Hb, and had similar ESA requirements. The fast-push injection of IIM may enable logistical benefits in clinical practice, and the low frequency of metallic taste contributes to patient convenience.. ClinicalTrials.gov identifier NCT02301026, study registered November 25, 2014.

Topics: Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Blood Transfusion; Combined Modality Therapy; Disaccharides; Drug Therapy, Combination; Dysgeusia; Female; Ferric Compounds; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Prospective Studies; Renal Dialysis; Renal Insufficiency, Chronic; Vitamin B 12

In 96 patients who visited our hospital with glossodynia, we conducted gustatory tests, measured serum zinc and copper levels, examined lingual papillae using biomicroscopy, conducted psychological tests and investigated the effectiveness of treatments directed at the cause of dysgeusia. Gustatory test results showed that 43 (44.8%) of the patients had dysgeusia, which was mild in 62.8%, moderate in 30.2% and severe in 7.0%. By giving higher priority to treatment of dysgeusia than to glossodynia, pain disappeared or was relieved and gustatory sensation improved in 27 (62.8%) of these 43 patients. Overall, pain disappeared or was improved in 65 (67.7%) cases. When treating glossodynia, it is important to diagnose the cause of pain and to give higher priority to treating that cause. The clinical efficacy of treatment for glossodynia will be improved when the presence or absence of dysgeusia is diagnosed early in the course of treatment.

Topics: Adult; Aged; Aged, 80 and over; Copper; Dysgeusia; Female; Glossalgia; Humans; Incidence; Iron; Male; Middle Aged; Vitamin B 12; Zinc