A Pilot Study of an Oral Absorbable Fat-Soluble Vitamin Formulation in Pediatric Patients with Cholestasis.

J Pediatr Gastroenterol Nutr. 2012 May 16;

Authors: Shen YM, Wu JF, Hsu HY, Ni YH, Chang MH, Liu YW, Lai HS, Hsu WM, Weng HL, Chen HL

Abstract
OBJECTIVE:: Fat-soluble vitamin deficiencies are common complications in pediatric patients with chronic cholestasis. The aim of this study was to evaluate the status of fat-soluble vitamin deficiencies in patients under current practice and to test the effect of an oral, absorbable, fat-soluble vitamin formulation (OAFSV) in these patients. METHODS:: We recruited a total of 23 pediatric patients receiving conventional fat-soluble vitamin supplementation in a single medical center, with diagnosis of biliary atresia (10), progressive familial intrahepatic cholestasis (9), Alagille syndrome (2), and other conditions (2). Ten patients switched to OAFSV and continued for 3 months. Plasma levels of vitamins A, D, and E and a normalized ratio (INR) for prothrombin time (PT), a surrogate marker for vitamin K deficiency, were measured. RESULTS:: The proportion of patients with fat-soluble vitamin A, D, E, and K deficiencies under conventional supplementation was 73.9%, 81.8%, 91.3%, and 20.0%, respectively. In patients with total bilirubin levels above 3.0 mg/dl, the proportion of at least one FSV deficiency was 100%; and the deficiency rates of vitamin A, D, E, and K were 78.6%, 100.0%, 100.0% and 21.4%, respectively. Of the 10 patients receiving standard daily dose of OAFSV for 3 months, no adverse events or overdose effects were found. The rates of vitamin A, D, and E deficiency in the patients receiving OAFSV decreased from 80.0%, 100%, and 100%, respectively; to 70.0%, 60.0%, and 60.0% after 3 months of oral supplementation. CONCLUSIONS:: High rates of fat-soluble vitamin deficiency were found in pediatric patients with chronic cholestasis under current follow-up. OAFSV supplementation is safe and potentially effective in pediatric cholestatic patients.

PMID: 22595974 [PubMed - as supplied by publisher]

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