Underestimated pyridoxine consumption and neurotoxicity: a novel manifestation with rheumatologic relevance - a case-based review

The impact of vitamin B complex has long been studied and utilized in clinical practice, both for healthy and diseased individuals. Its beneficial effects on physical and mental performance have been proven by multiple studies leading to widespread supplementation among the general population. As of today's knowledge, vitamin B6 (pyridoxine) in excessive doses may lead to symptoms of neuropathy. Unfortunately, many of those supplementing vitamin B complex are unaware of such a risk. This case-based review presents three patients who initially searched for help due to neuropathic symptoms with the rheumatological diagnostic process following. All of them had a history of excessive vitamin B6 consumption, though through different sources. Cessation of supplementation led to prompt improvement in symptoms. These cases stress the importance of in-depth history taking and specifying instructions regarding prescribed supplements. The novelty of this article lies in the description of a patient who reported symptoms associated with central nervous system with concomitant abnormalities of the complement system, all of which resolved spontaneously upon normalization of pyridoxine concentration.