Pancytopenia Caused by Nitrous Oxide Toxicity: Two Cases Report

Recreational nitrous oxide (N2O) is increasingly common among young people, leading to attendant health disadvantages. Related complications primarily involve the hematological and neurological systems. We report two relatively uncommon cases of pancytopenia due to substantial N2O inhalation. One possible cause is that N2O toxicity results in vitamin B12 inactivation and an insufficient intake of nutrients. The patient’s symptoms partially improved after cessation of N2O inhalation and supplementation with vitamin B12. In conclusion, if the patients presented with unexplained bone marrow failure, a history of prolonged N2O exposure should be considered, which would greatly help in early diagnosis, therapy, and the reduction of unnecessary costs.