Trombo-embolische complicaties na recreatief lachgasgebruik

Thromboembolic Complications Following Recreational Nitrous Oxide Use A 25-year-old man presented with severe abdominal pain, vomiting, and thoracic pain following prolonged recreational use of nitrous oxide. Initially, urolithiasis or cholecystitis was suspected, but subsequent imaging, including ultrasound and CT-scan, revealed venous thrombosis in the right renal vein extending into the inferior vena cava. A follow-up CT-scan of the thorax confirmed the presence of bilateral pulmonary emboli. Laboratory tests showed significantly elevated homocysteine levels due to vitamin B12 deficiency, with no other apparent risk factors for thrombosis. The diagnosis of thromboembolic complications resulting from excessive nitrous oxide use was made. The treatment involved vitamin B12 supplementation and anticoagulants, leading to clinical improvement. This case underscores the importance of awareness among both healthcare providers and patients regarding the potentially severe complications of recreational nitrous oxide use, including neurotoxic damage, hematological issues, and cardiovascular complications such as thrombosis. The increasing abuse of nitrous oxide, particularly among young adults, highlights the need for early recognition and appropriate treatment to prevent potentially life-threatening complications. This case also demonstrates the importance of a multidisciplinary approach to care for this patient population. Psychosocial support was offered but refused by the patient. Ultimately, the combination of vitamin B12 supplementation and anticoagulants was key to achieving clinical recovery.