Abstract
Objective:Folate, vitamin B12 and iron are important vitamin and minerals which play role in the development of nervous system. The aim of this study was looking at the presence of folate, vitamin B12 and iron deficiency among patients with Primary nocturnal enuresis (PNE) and possible relation between the delay of central nervous system (CNS) development, PNE and folate, vitamin B12 and iron states.Methods: Consecutively applied forty patients with PNE (23 girls and 17 boys) and otherwise normal thirty control subjects (17 girls and 13 boys) were included in the study. Average ages (in range) of PNE and the control group were 9.2(6-12) years and 9.3 (6-12) years accordingly. Age, height, weight, complete blood count, blood vitamin B12, folate, ferritin and iron values of both groups were recorded and compared to each other.Results:Average vitamin B12 and folate levels of patients with PNE were significantly and statistically lower compared to those of the control group. Average blood iron of patients with PNE was significantly higher than that of the control group and also average ferritin level of the PNE group was detected to be higher than the control group but this relation was statistically insignificant.Conclusion: Primary nocturnal enuresis is related to the delay in CNS maturation so it was thought that low vitamin B12 and folate which were found in patients with PNE may have role in the delay of CNS maturation. Additionally, further studies are needed to investigate the role of vitamin B12 and folate either alone or as combination in treatment of patients with PNE who have low vitamin B12and folate level.
Highlights
According to The International Children’s Continence Society (ICCS), enuresis has been described as normal voiding that occurs at an unsuitable and socially intolerable time and place.[1]
It was found that vitamin B12 and folate needed for central nervous system (CNS) maturation was lower among patients with Primary nocturnal enuresis (PNE) compared to the control group
These results were in parallel to the literature and it implies the role of retardation of CNS maturation in pathogenesis of PNE and it suggests possible relation between low vitamin B12 and folate, and delay in CNS maturation
Summary
According to The International Children’s Continence Society (ICCS), enuresis has been described as normal voiding that occurs at an unsuitable and socially intolerable time and place.[1] Primary nocturnal enuresis (PNE) is a common finding in school-age children, with a prevalence rate around 9% in children between 5 and 10 years of age.[2]. A successful urotherapy can save a patient from excessive medical interventions and other alternative treatment options.[3] Biofeedback method without drug usage which needs active parent and child participation can be alternative treatment modality due to its short-term satisfactory results in enuresis nocturna.[4] ICCS endorses the use of desmopressin as a first-line treatment for primary nocturnal enuresis of polyuric origin (level 1, grade A).[5]
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