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Treatment of vitamin K deficiency in cystic fibrosis: Effectiveness of a daily fat-soluble vitamin combination.

Abstract

OBJECTIVE

Patients with cystic fibrosis (CF) and pancreatic insufficiency (PI) commonly have vitamin K deficiency, and those with CF-associated liver disease (CFLD) have universal vitamin K deficiency. We evaluated the effectiveness of an oral fat-soluble vitamin combination (ADEKs) to treat patients with vitamin K deficiency.

STUDY DESIGN

Patients with PI and CF (mean age, 15 years; range, 0.6 to 46 years) including 6 with advanced CFLD were prospectively enrolled in a study of a fat-soluble vitamin combination taken on a daily basis. None had received vitamin K supplementation for at least 4 months before the study. Fat-soluble vitamin combination supplementation was given for a minimum of 4 months; the mean vitamin K intake was 0.18 mg/d (SD = 0.1, range, 0 to 0.3). The primary outcome was change in plasma PIVKA-II (prothrombin in vitamin K absence).

RESULTS

Before supplementation 58 (81%) of 72 patients had abnormal PIVKA-II levels (>2.9 ng/mL). After supplementation 29 (40%) had abnormal PIVKA-II levels (P =.001). All 6 patients with advanced CFLD had abnormal PIVKA-II levels (median, range of 20.8, 5.5 to 55 ng/mL) before treatment, which corrected to normal in 50% (4.1, 2.1 to 65 ng/mL). Four patients, 2 with CFLD, had a prolonged prothrombin time (>13.5 seconds) at both time periods.

CONCLUSIONS

An oral fat-soluble vitamin combination with a modest amount of vitamin K can, as a daily supplement, improve the PIVKA-II levels in patients with PI and CF.

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  • Authors+Show Affiliations

    ,

    Division of Gastroenterology/Nutrition, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada, M5G 1X8.

    , , , , , , , ,

    Source

    The Journal of pediatrics 138:6 2001 Jun pg 851-5

    MeSH

    Adolescent
    Adult
    Biomarkers
    Child
    Child, Preschool
    Cystic Fibrosis
    Female
    Humans
    Infant
    Liver Diseases
    Male
    Middle Aged
    Prospective Studies
    Protein Precursors
    Prothrombin
    Prothrombin Time
    Vitamin K
    Vitamin K Deficiency
    Vitamins

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11391328

    Citation

    Wilson, D C., et al. "Treatment of Vitamin K Deficiency in Cystic Fibrosis: Effectiveness of a Daily Fat-soluble Vitamin Combination." The Journal of Pediatrics, vol. 138, no. 6, 2001, pp. 851-5.
    Wilson DC, Rashid M, Durie PR, et al. Treatment of vitamin K deficiency in cystic fibrosis: Effectiveness of a daily fat-soluble vitamin combination. J Pediatr. 2001;138(6):851-5.
    Wilson, D. C., Rashid, M., Durie, P. R., Tsang, A., Kalnins, D., Andrew, M., ... Pencharz, P. B. (2001). Treatment of vitamin K deficiency in cystic fibrosis: Effectiveness of a daily fat-soluble vitamin combination. The Journal of Pediatrics, 138(6), pp. 851-5.
    Wilson DC, et al. Treatment of Vitamin K Deficiency in Cystic Fibrosis: Effectiveness of a Daily Fat-soluble Vitamin Combination. J Pediatr. 2001;138(6):851-5. PubMed PMID: 11391328.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Treatment of vitamin K deficiency in cystic fibrosis: Effectiveness of a daily fat-soluble vitamin combination. AU - Wilson,D C, AU - Rashid,M, AU - Durie,P R, AU - Tsang,A, AU - Kalnins,D, AU - Andrew,M, AU - Corey,M, AU - Shin,J, AU - Tullis,E, AU - Pencharz,P B, PY - 2001/6/8/pubmed PY - 2001/7/13/medline PY - 2001/6/8/entrez SP - 851 EP - 5 JF - The Journal of pediatrics JO - J. Pediatr. VL - 138 IS - 6 N2 - OBJECTIVE: Patients with cystic fibrosis (CF) and pancreatic insufficiency (PI) commonly have vitamin K deficiency, and those with CF-associated liver disease (CFLD) have universal vitamin K deficiency. We evaluated the effectiveness of an oral fat-soluble vitamin combination (ADEKs) to treat patients with vitamin K deficiency. STUDY DESIGN: Patients with PI and CF (mean age, 15 years; range, 0.6 to 46 years) including 6 with advanced CFLD were prospectively enrolled in a study of a fat-soluble vitamin combination taken on a daily basis. None had received vitamin K supplementation for at least 4 months before the study. Fat-soluble vitamin combination supplementation was given for a minimum of 4 months; the mean vitamin K intake was 0.18 mg/d (SD = 0.1, range, 0 to 0.3). The primary outcome was change in plasma PIVKA-II (prothrombin in vitamin K absence). RESULTS: Before supplementation 58 (81%) of 72 patients had abnormal PIVKA-II levels (>2.9 ng/mL). After supplementation 29 (40%) had abnormal PIVKA-II levels (P =.001). All 6 patients with advanced CFLD had abnormal PIVKA-II levels (median, range of 20.8, 5.5 to 55 ng/mL) before treatment, which corrected to normal in 50% (4.1, 2.1 to 65 ng/mL). Four patients, 2 with CFLD, had a prolonged prothrombin time (>13.5 seconds) at both time periods. CONCLUSIONS: An oral fat-soluble vitamin combination with a modest amount of vitamin K can, as a daily supplement, improve the PIVKA-II levels in patients with PI and CF. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/11391328/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(01)96467-4 DB - PRIME DP - Unbound Medicine ER -