Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Mager, D R; McGee, P L; Roberts, E A; Furuya, K N
Division of Gastroenterology and Nutrition and The Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Children with liver disease are at risk for developing vitamin K deficiency secondary to fat malabsorption and inadequate dietary intake. The aim of this study was to assess vitamin K status in cholestatic (n=22) and non-cholestatic (n=20) children with liver disease. Mean age (± SD) of children in the study was 8.27 ± 5.52 years. 12/42 children were supplemented with vitamin K in the form of a multivitamin (0.2 mg/d) or a single vitamin preparation (5 mg, 2 to 7 times/week). Vitamin K status was assessed by plasma PIVKA-II (prothrombin induced in vitamin K absence) levels (ELISA assay, a sensitive marker of vitamin K). Baseline blood work (prothrombin time (PT), alk phos, γ-GT, AST, conjugated/unconjugated/delta bilirubin, bile salts, albumin, vitamin A and E) was obtained to assess the relationship of vitamin K status to the biochemical parameters. Severity of liver disease was assessed by the Child-Turcotte classification and modified Pugh score. Mean plasma PIVKA-II in children with cholestatic and non-cholestatic liver disease was 58.9 ± 112.6 and 0.03 ± 0.18 ng/ml, respectively. 10/22 (45%) cholestatic children had plasma PIVKA-II values > than 2 ng/ml (reflects vitamin K deficiency), while only 1 child had a prolonged PT. Conjugated, delta, and total bilirubins, Child-Turcotte classification and Pugh scores positively correlated with plasma PIVKA II levels (p<0.05) in all patients studied. There was a negative correlation between albumin and plasma PIVKA-II levels in cholestatic children (p<0.05). No significant correlation was found between plasma PIVKA-II levels and the other biochemical parameters measured. Conclusion: This pilot study demonstrates that sub-clinical vitamin K deficiency is prevalent in children with chronic cholestatic liver disease. Elevated PIVKA-II levels occurred in the presence of a normal PT, indicating that PT is not an adequate marker of vitamin K status in children with liver disease. Furthermore, we found that Vitamin K deficiency was associated with the degree of cholestasis and severity of liver disease.
POSTER SESSION II
© 1999 Lippincott Williams & Wilkins, Inc.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Pediatric Gastroenterology and Nutrition.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in for
days or until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Visit JPGN.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.