Assessment of vitamin D status in common variable immunodeficiency or ataxia–telangiectasia patients

Cruz, J.R.S.; Silva, R.; Andrade, Itana Gomes Alves; Fonseca, Fernando Luiz Affonso; Costa‐Carvalho, Beatriz Tavares; Sarni, Roseli Saccardo

doi:10.1016/j.aller.2019.03.004

Cited by 7 publications

(4 citation statements)

References 25 publications

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“…Deficiencies of iron, folic acid, zinc, iodine, vitamin D and vitamin A are the most common micronutrient deficiencies worldwide [ 19 , 20 ], but not all measurements are widely available in daily practice. In the available literature, there are only single reports of vitamin D deficiencies in patients with humoral immunodeficiencies [ 21 , 22 ]. Research conducted by Cruz JRS et al [ 21 ] and Amaya-Mejía AS et al [ 22 ] included a very small group of subjects (15 and 20 patients with CVID, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…In the available literature, there are only single reports of vitamin D deficiencies in patients with humoral immunodeficiencies [ 21 , 22 ]. Research conducted by Cruz JRS et al [ 21 ] and Amaya-Mejía AS et al [ 22 ] included a very small group of subjects (15 and 20 patients with CVID, respectively). Vitamin D deficiency was found in 13% and 30% of patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies

Napiórkowska-Baran,

Ziętkiewicz,

Więsik-Szewczyk

et al. 2023

JCM

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An improved recognition of inborn errors of immunity (IEI) is associated with an increase in life expectancy and a higher incidence of complications and related conditions. The aim of the study was to analyze factors enabling the primary prevention: BMI, smoking and selected laboratory tests (morphology with smear, creatinine, eGFR, total protein, albumin, ferritin, folic acid, vitamin B12, vitamin D3) included in the protocols of standard of care for adult patients with primary antibody deficiencies (PADs). The study included 94 participants ≥ 18 years old, diagnosed with PADs. Overweight was found in 17%, obesity in 14% and underweight in 15% of patients; 11.5% of patients smoked. Leukopenia was diagnosed in 16%, neutropenia in 8.5%, lymphopenia in 22.5% and thrombocytopenia in 14% of patients. A decreased concentration of hemoglobin was found in 32%, total protein in 19%, albumin in 17%, vitamin D3 in 52%, vitamin B12 in 6.5%, folic acid in 34% and ferritin in 26% of patients. Creatinine concentrations were elevated in 16% of patients, while in 20%, eGFR was reduced. Only a holistic assessment of comorbidities and complications of deficiency, as well as regular follow-up and lifestyle changes, can yield the best results in the long-term care of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies

Napiórkowska-Baran,

Ziętkiewicz,

Więsik-Szewczyk

et al. 2023

JCM

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“…The clinical manifestation of malabsorption syndromes vary between protein-losing enteropathy (PLE), small bowel wall thickening with potential obstruction and rarely exudative ascites. Important examples of generalized malabsorption enteropathies are outlined in Table 1 [1][2][3][4][5][6][7][8][9][10][11][12]13 && ,14 -22]. However, the primary focus of this article is on the current and pipeline tests for workup of small bowel diseases causing selective malabsorption, which often pose a clinical challenge.…”

Section: Introductionmentioning

confidence: 99%

A look inside the gut as a clue to nutritional status

Bar,

Abdelgani,

Lal

et al. 2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review Malabsorption and malnutrition are common gastrointestinal manifestations clinicians face, requiring diagnostic workup for effective diagnosis and management of the underlying cause. This review discusses recent advances in diagnostic approaches to malabsorption and maldigestion of macronutrients – lipids, proteins, and carbohydrates. We highlight underrecognized causes, available testing modalities, and ongoing diagnostic unmet needs. Recent findings Innovations in the diagnostic landscape are enhancing our understanding of malabsorption syndromes. Stool collection and handling is uncomfortable and commonly avoided. The objective quantification of stool lipids, bile acids, and gut enzymes is therefore underused in the diagnosis and management of common disorders such as exocrine pancreatic insufficiency, bile acid diarrhea, protein-losing enteropathy, and more. We review the recent advancements in spot quantification of stool fat and bile acid content, endoscopic imaging techniques such as endocytoscopy, confocal laser endomicroscopy, and optical coherence tomography and the future place in clinical practice. Summary Malabsorption and maldigestion represent significant challenges in clinical nutrition and gastroenterology. Through the integration of advanced diagnostic techniques, clinicians will be better equipped to tailor therapy and monitor treatment response, ultimately improving patient health outcomes. This review underscores the critical role of innovative diagnostic tools in accurately detecting and effectively managing gastrointestinal disorders linked to nutritional status.

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“…Patients are prescribed vitamin D 3 as two Divisun tablets at 800 IU each or as Detremin, 3 drops at 500 IU/drop, yielding daily doses of 1600 or 1500 IU/day, respectively [11]. Previous studies have shown that vitamin D deficiency is rather common among immunodeficient patients, and that approximately half of such patients have 25-OHD<50 nmol/L [11][12][13] In 2013, the clinical effects of the new guidelines were evaluated in a prospective, observational follow-up study comparing antibiotic use during a 12 month period before and after initiating supplementation in immunodeficient patients (n = 277) [11]. The results showed a significant reduction in the number of days on antibiotic treatment, a reduction in the number of prescriptions of antibiotics, and an increased number of entirely antibiotic-free patients.…”

Section: Introductionmentioning

confidence: 99%

Are Vitamin D3 Tablets and Oil Drops Equally Effective in Raising S-25-Hydroxyvitamin D Concentrations? A Post-Hoc Analysis of an Observational Study on Immunodeficient Patients

et al. 2020

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Background: Vitamin D3 supplements are available as tablets or oil drops, but there is no consensus as to whether either of these preparations is more effective than the other. Methods: We compared the effectiveness of tablets versus oil in raising S-25-hydroxyvitamin D (S-25-OHD) in plasma by re-analyzing data from a previously performed observational study in which immunodeficient patients with S-25-OHD concentrations <75 nmol/L were randomly prescribed vitamin D3 tablets (1600 IU/day) or vitamin D3 oil-drops (1500 IU/day) for twelve months. Tablets and oil were compared for the effect on S-25-OHD concentrations after 3–5 months and antibiotic use. Results: Data on S-25-OHD after ≥ 3 months was available for 137 patients treated with tablets and 69 with oil drops. Both groups exhibited a significant increase in S-25-OHD—oil-drops from 55 to 86 nmol/L and tablets from 52 to 87 nmol/L—with no difference between groups (p = 0.77). In a subgroup of patients without immunoglobulin replacement, vitamin D3 supplementation with oil drops (n = 34) but not with tablets (n = 60) resulted in significantly lower antibiotic administration (p < 0.001 and p = 0.58). Conclusion: Vitamin D3 supplementation with tablets and oil drops were equally efficient in raising S-25-OHD concentrations. Only oil drops caused a reduction in antibiotic consumption in immuno-deficient patients who did not receive immunoglobulin replacement.

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Assessment of vitamin D status in common variable immunodeficiency or ataxia–telangiectasia patients

Cited by 7 publications

References 25 publications

Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies

Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies

A look inside the gut as a clue to nutritional status

Are Vitamin D3 Tablets and Oil Drops Equally Effective in Raising S-25-Hydroxyvitamin D Concentrations? A Post-Hoc Analysis of an Observational Study on Immunodeficient Patients

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