Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; University of Toronto, Canada.
Division of Gastroenterology, Hepatology and Nutrition, Siragusa Transplant Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue Box 57, Chicago, IL 60611, USA.
Clin Liver Dis. 2022 Aug;26(3):537-553. doi: 10.1016/j.cld.2022.03.011. Epub 2022 Jun 25.
Malnutrition in children with chronic cholestasis is a prevalent issue and a major risk factor for adverse outcomes. Fat soluble vitamin (FSV) deficiency is an integral feature of cholestatic disease in children, often occurring within the first months of life in those with neonatal cholestasis and malnutrition. This review focuses on FSVs in cholestasis, with particular emphasis on a practical approach to surveillance and supplementation that includes approaches that account for differing local resources. The overarching strategy suggested is to incorporate recognition of FSV deficiencies in cholestatic children in order to develop practical plans for close monitoring and aggressive FSV repletion. Routine attention to FSV assessment and supplementation in cholestatic infants will reduce long periods of inadequate levels and subsequent adverse clinical sequalae.
儿童慢性胆汁淤积症中存在营养不良的问题，这是一个普遍的现象，也是不良预后的主要危险因素。脂溶性维生素（FSV）缺乏是儿童胆汁淤积症的一个固有特征，在新生儿胆汁淤积症和营养不良的患儿中，这种缺乏通常在生命的最初几个月就会出现。本综述重点介绍了胆汁淤积症中的 FSV 问题，并特别强调了一种实用的监测和补充方法，其中包括考虑到不同当地资源的方法。建议的总体策略是在胆汁淤积患儿中认识到 FSV 缺乏，以便制定密切监测和积极补充 FSV 的实用计划。常规关注胆汁淤积婴儿的 FSV 评估和补充，将减少长时间的 FSV 水平不足及随后的不良临床后果。
