http://www.ncbi.nlm.nih.gov/pubmed/22595974
Oral Absorbable Fat-soluble Vitamin Formulation in Pediatric Patients With Cholestasis
Journal of Pediatric Gastroenterology and Nutrition, 11/13/2012

Shen YM et al. – High rates of Fat–soluble vitamin (FSV) deficiency were found in pediatric patients with chronic cholestasis under present follow–up. Oral, absorbable, fat–soluble vitamin formulation (OAFSV) supplementation is safe and potentially effective in pediatric patients with cholestasis.

Methods

    The authors recruited a total of 23 pediatric patients receiving conventional FSV 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 an international normalized ratio (INR) for prothrombin time (PT), a surrogate marker for vitamin K deficiency, were measured.

Results

    The proportion of patients with FSV 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 >3.0mg/dL, the proportion of at least 1 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.