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Treatment of vitamin K deficiency in cystic fibrosis: Effectiveness of a daily fat-soluble vitamin combination.
J Pediatr 2001; 138(6):851-5JPed

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.

Authors+Show Affiliations

Division of Gastroenterology/Nutrition, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada, M5G 1X8.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -