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Patients who have early Leber's disease (hereditary optic nerve atrophy) have been found to suffer severe and swift optic atrophy when treated with vitamin B12

Decreased levels of retinoic acid in turn increase the phosphorylation of mitogen-activated protein kinases (MAPKs) and downregulate the expression of the anti-inflammatory protein mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1), which supports carcinogenesis in the lungs

10.1016/0042-6822(60)90163-x 48 FodorJ.GullnerG.dmA

Moreover, there is also huge variability regarding patients age, as some etiologies, like acute viral hepatitis, are more frequent in the pediatric population and others, like DILI, are more common in elderly patients