Mechanism Causing Vitamin E Deficiency During Chronic Childhood Cholestasis

R. J. Sokol, J. E. Heubi, S. Iannaccone, K. E. Bove, W. F. Balistreri

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Abstract

In order to characterize the mechanism(s) causing vitamin E deficiency during chronic childhood cholestasis, we studied 6 vitamin E-deficient cholestatic children with clinical evidence of neurologic dysfunction (group A), 4 vitamin E-sufficient cholestatic children and young adults with normal neurologic status (group B), and 6 vitamin E-sufficient noncholestatic children (group C). Intestinal absorption of dl-α-tocopherol (assessed by an oral tolerance test) was markedly impaired (p < 0.001) in group A compared with groups B and C, which did not differ from each other. Intraluminal total bile acid concentrations were markedly depressed in group A compared with age-matched controls (0.50 vs. 7.00 mM, p < 0.001), whereas concentrations were low normal in group B. Intramuscular dl-α-tocopherol was well absorbed in 4 group A subjects and corrected abnormal hydrogen peroxide hemolysis. Our data suggest that low intraluminal bile acid concentrations result in malabsorption and deficiency of vitamin E in children with prolonged, severe cholestasis. Intact plasma transport and tissue uptake of vitamin E during cholestasis suggest that intramuscular vitamin E should be utilized for prevention and therapy of the neurologic abnormalities caused by vitamin E deficiency.

Original languageEnglish (US)
Pages (from-to)1172-1182
Number of pages11
JournalGastroenterology
Volume85
Issue number5
DOIs
StatePublished - Jan 1 1983

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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