A Case Report on Pantoprazole Induced VIT.B12 Deficiency

Abstract

A 40 yr old male patient suffering with GERD was initially prescribed with Pantoprazole 40 mg OD for 15 days. After the treatment, suddenly the patient started feeling uncharacterized dizziness and fatigue. The patient consulted his physician who is a gastroenterologist. After a thorough examination the physician asked the patient for blood tests which revealed that the Hb is normal but the amount of Vit.B 12 present in the blood is less than the normal. It was confirmed that, after the use of Pantoprazole, Vit.B 12 blood levels have decreased which lead to the symptoms. This case report summarizes that on long term use of pantoprazole should be supported by supplemental therapy with Vit.B 12. Background: Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favourable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastroesophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. One area that is receiving much attention and generally has been poorly studied is the long-term effects of chronic acid suppression on the absorption of vitamins and nutrients. An ADR report concerning a patient who developed vitamin B 12 deficiency while being treated with pantoprazole. The patient, who had been treated with panto-prazole 40 mg for gastroesophageal reflux disease with gastric ulcer for 15 days. After this, the patient consulted his physician about uncharacteristic symptoms including periodic dizziness. Blood examinations revealed Vitamin B 12 deficiency. The patient was examined, and no other causes were found that could explain the inability to absorb Vitamin B 12. After Pantoprazole was discontinued, serum B 12 levels normalized.