Acute folate deficiency in a critically ill patient

Micronutrient Alterations During Continuous Renal Replacement Therapy in Critically Ill Adults: A Retrospective Study

“…The incidence of folic acid deficiency in the critically ill patient has varied from 2%–19% in various studies . Acute folate deficiency for critically ill patients, despite normal serum levels, has also been reported; this may be explained by a potential uremic effect that leads to an alteration of folate metabolism through inhibition of hepatic folate store mobilization . Folate loss of 290 mcg/d due to continuous venovenous hemofiltration has been reported .…”

Serum concentrations and clearances of folic acid and pyridoxal-5′-phosphate during venovenous continuous renal replacement therapy

“…They also showed that sepsis, post-operative period, and gastrointestinal surgery were risk factors for folic acid deficiency. Geerlings et al [7] reported a case of acute folate deficiency manifesting as cytopenias and compatible bone marrow changes, but normal serum and red cell folate concentrations; the patient had multiple organ dysfunction and was treated by CRRT. In regard to vitamin B6, no similar findings are available to our knowledge.…”

“…Although vitamin status has been studied in chronic dialysis patients, not much information is available for continuous renal replacement therapy (CRRT) used in patients in the intensive care unit (ICU). Recently, a case report has described an acute folate deficiency in a critically ill patient treated by CRRT [7]. In addition, it is now recognized that the cumulative clearance and removal of several solutes are considerable during CRRT, particularly when performed at a high filtrate volume.…”

The Hematologic System as a Marker of Organ Dysfunction in Sepsis

“…101 Acute folate deficiency has been described in patients admitted to the ICU. 102 Preexisting underlying disease, including cancer and immune thrombocytopenic purpura, may also contribute to a low platelet count.…”