B6 and Bleeding: A Case Report of a Novel Vitamin Toxicity

Borst, Alexandra J.; Tchapyjnikov, Dmitry

doi:10.1542/peds.2017-2039

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…53 PLP has an excellent safety profile, although prolonged supraphysiological supplementation may lead to progressive peripheral neuropathy 57,58 , and a dose of 43 mg/kg per day (> 1 gram per day) in a 4 year old patient with hemophilia was associated with recurrent spontaneous hemarthroses. 59 It should also be noted that very high doses of pyridoxine inhibit the active PLP form in vitro. 60 Therefore, it may be prudent to attempt treatment and trials, at least initially, with the PLP form of the vitamin.…”

Section: Plp As a Weapon Against Covid-19mentioning

confidence: 99%

<strong>Pyridoxal 5'-phosphate to mitigate immune dysregulation and coagulopathy in COVID-19</strong>

Desbarats¹

2020

Preprint

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Although most cases of COVID-19 are paucisymptomatic, severe disease is characterized by immune dysregulation, with a decreased type I interferon response, increased inflammatory indicators, surging IL-6, IL-10 and TNFα suggestive of cytokine storm, progressive lymphopenia, and abnormal blood clotting. Factors determining susceptibility to severe disease are poorly understood, although mortality correlates with increasing age and co-morbidities including diabetes and cardiovascular disease (CVD). Pyridoxal 5'-phosphate (PLP) tends to be insufficient in populations particularly vulnerable to COVID-19, including the elderly, the institutionalized, and people with diabetes and CVD, and PLP becomes further depleted during infection and inflammation. In turn, low PLP results in immune imbalance, as PLP is an essential cofactor in pathways regulating cytokine production, in particular type I interferons and IL-6, and in lymphocyte trafficking and endothelial integrity. Furthermore, normalizing PLP levels attenuates abnormalities in platelet aggregation and clot formation. Finally, PLP insufficiency induces excess secretion of renin and angiotensin, and hypertension. In inflammatory disease, pharmacological doses of PLP decrease circulating TNFα, IL-6 and D-dimer, and animal studies demonstrate that supplemental PLP shortens the duration and severity of viral pneumonia. Severe COVID-19 manifests as an imbalance in the immune response and the clotting system. Pharmacological PLP supplementation may therefore mitigate COVID-19 symptoms by alleviating both the immune suppression underlying viral spread and the pathological hypersecretion of inflammatory cytokines, as well as directly bolstering endothelial integrity and preventing hypercoagulability.

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Section: Plp As a Weapon Against Covid-19mentioning

confidence: 99%

<strong>Pyridoxal 5'-phosphate to mitigate immune dysregulation and coagulopathy in COVID-19</strong>

Desbarats¹

2020

Preprint

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“…Two other reports also are warning case reports. One relates a vitamin B6 toxicity, 19 and the other relates a drug reaction with eosinophilia and systemic symptoms to oxcarbazepine in a patient with a specific immunotype. 20…”

Section: Early Alert Regarding Untoward Consequencesmentioning

confidence: 99%

The Case for the Case Report

Malatack

2018

Pediatrics

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Case reports at one time could be found in many if not most medical journals. I found that 40 years ago, the top 10 pediatric journals all published case reports (many with designated case report sections), and 30% of the articles published in the 10 journals collectively were case reports. Twenty years ago, these same journals had reduced their case report publications, averaging only 15% of their published articles, with many having dropped a case report section altogether. In 2016, case reports only accounted for 4% of articles published in this same group of journals, with Pediatrics at 11% being the most committed to this format of medical publication. Pediatrics also is the only one of these publications with a designated section for case reports. Pediatrics' recent decision to reduce the number of published case reports from a maximum of 8 an issue to 3 an issue is the latest in this long decline. It appears that 2 forces have had a role in the decline of the case report as a genre of medical publications. The 2 forces include the impact factor, created in the 1990s, and the inability to use statistical methodology to assess the data at hand. The impact factor is a measure of the frequency with which the average article in a journal has been cited from a particular year. It is used to measure the importance or rank of a journal by calculating the times its articles are cited. A 2-year period is used and involves dividing the number of times articles that were cited in that 2-year period after publication by the number of articles that are potentially citable. Case reports are handled, for this purpose, as are original articles. Case Reports, for reasons outlined below, are invariably not going to be cited as often as original articles by the 2-year postpublication period that defines the impact factor. The other force that has led to the decline of case reports is the inability to apply statistical analysis to strengthen the scientific merit of the report. In the words of one of my coeditors, "You can't tell anything from a single case." The error in this reasoning is the supposition that a case report and an original article have anything in common. They don't.

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“…Studies have shown that consuming more vitamin C can increase blood antioxidant levels by up to 30%. 6 Unlike vitamin K2, vitamin K1also called phylloquinone, is obtained from the diet, Deficiency symptoms include possible hemolytic anemia and hyperbilirubinemia (jaundice) in infants. 7 The minerals that are important for complementary infant foods are: magnesium calcium, iron, zinc and manganese.…”

Section: Introductionmentioning

confidence: 99%

Comparable Vitamin and Mineral Contents of Co-Fermented Maize/Carrot/ Pigeon Pea and Co-Fermented Millet/ Sweet Potato/Pigeon Pea as Infant Complementary Food

2022

TJNPR

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This study investigated the vitamin content, mineral composition, and functional properties of co-fermented maize/carrot/pigeon pea (MACP) and co-fermented millet/sweet potato/pigeon pea (MISP) as infant complementary foods using standard methods. The vitamin content and mineral composition as well as functional properties were determined using standard procedures. From the results, vitamin contents of MACP are: Vitamin A (52.63-6.08μg) vitamin (B1,(0.23-0.10), B2, (0.12-0.09), B3, (1.45-1.25μg) B5,( 0.41-0.12) B6,( 0.19-0.25) B9 ( 0.00-0.00 μg), C( 2.026-14.99), E (0.12-0.12), and total vitamin content (77.50 -25.09). For MISP, the vitamin contents are:

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B6 and Bleeding: A Case Report of a Novel Vitamin Toxicity

Cited by 6 publications

References 19 publications

<strong>Pyridoxal 5'-phosphate to mitigate immune dysregulation and coagulopathy in COVID-19</strong>

<strong>Pyridoxal 5'-phosphate to mitigate immune dysregulation and coagulopathy in COVID-19</strong>

The Case for the Case Report

Comparable Vitamin and Mineral Contents of Co-Fermented Maize/Carrot/ Pigeon Pea and Co-Fermented Millet/ Sweet Potato/Pigeon Pea as Infant Complementary Food

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