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.

• Authors: D C Wilson, M Rashid, P R Durie, A Tsang, D Kalnins, M Andrew, M Corey, J Shin, E Tullis, P B Pencharz
• Journal: The Journal of pediatrics (J Pediatr) Vol. 138 Issue 6 Pg. 851-5 (Jun 2001) ISSN: 0022-3476 [Print] United States
• PMID: 11391328 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Protein Precursors
• Vitamins
• Vitamin K
• acarboxyprothrombin
• Prothrombin

Topics

• Adolescent
• Adult
• Biomarkers
• Child
• Child, Preschool
• Cystic Fibrosis (complications)
• Female
• Humans
• Infant
• Liver Diseases (complications)
• Male
• Middle Aged
• Prospective Studies
• Protein Precursors (blood)
• Prothrombin
• Prothrombin Time
• Vitamin K (administration & dosage)
• Vitamin K Deficiency (complications, drug therapy)
• Vitamins (administration & dosage)