The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL
Reva Frankel, Courtney Verscaj, Christina G Tise, Kristina Cusmano-Ozog
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引用次数: 0

Abstract

There has been a multivitamin infusion (MVI) shortage for the last decade, generating increasing concerns for the neonatal population. This study evaluated a cohort of 4 total parenteral nutrition (TPN)-dependent neonates who presented within a 6-month period with abnormal biochemistry in a complex and unusual pattern. All exhibited findings were suggestive of multiple inherited metabolic disorders (IMD), particularly multiple acyl-CoA dehydrogenase deficiency and maple syrup urine disease. Given the rarity of having 2 IMDs, communication with the primary team was initiated and revealed inadequate MVI in the administered TPN. All biochemical abnormalities could be explained by thiamine (B1), riboflavin (B2), pyridoxine (B6), and/or biotin (B7) deficiency. MVI-deficient TPN as the single unifying etiology is further supported by normal newborn screening (NBS) and resolution of biochemical abnormalities with MVI administration in all neonates. Awareness of this problem is critical to avoid unnecessary testing and initiate prompt treatment with vitamins.

新生儿复合维生素缺乏对临床及生化的影响。
在过去的十年中,多种维生素输注(MVI)短缺,引起了对新生儿人口越来越多的关注。本研究评估了4名全肠外营养(TPN)依赖的新生儿,他们在6个月内以复杂和不寻常的模式出现了异常的生物化学。所有的研究结果都提示多重遗传代谢紊乱(IMD),特别是多重酰基辅酶a脱氢酶缺乏症和枫糖浆尿病。考虑到2个imd的罕见性,我们开始与初级团队沟通,发现在实施的TPN中MVI不足。所有生化异常均可由硫胺素(B1)、核黄素(B2)、吡哆醇(B6)和/或生物素(B7)缺乏来解释。正常新生儿筛查(NBS)和所有新生儿给予MVI后生化异常的解决进一步支持MVI缺陷TPN作为单一的统一病因。意识到这个问题对于避免不必要的检测和及时开始维生素治疗至关重要。
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
165
审稿时长
12 weeks
期刊介绍: The AFMR is committed to enhancing the training and career development of our members and to furthering its mission to facilitate the conduct of research to improve medical care. Case reports represent an important avenue for trainees (interns, residents, and fellows) and early-stage faculty to demonstrate productive, scholarly activity.
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