Anemia attributed to vitamin B6 deficiency in post-pancreaticoduodenectomy patients

Yasuda, Hajime; Fujiwara, Noriko; Ishizaki, Yoichi; Komatsu, Norio

doi:10.1016/j.pan.2014.12.001

Cited by 18 publications

(14 citation statements)

References 11 publications

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“…She was then maintained on a regular diet, pancreatic enzymes, and a multivitamin/mineral supplement. Other similar cases have been described with similar treatment and maintenance utilizing adequate PERT 69 – 71 …”

Section: Other Vitamins and Mineralsmentioning

confidence: 71%

“…Confirmation of diagnosis may be made by measuring response to supplemental zinc 67 . Zinc deficiency has been reported following surgery for pancreatic cancer in case reports and small retrospective evaluations 46 , 50 , 68 – 70 . Deficiency is thought to be related to disturbance of zinc absorption in the jejunum as well as poor protein absorption and, therefore, poor zinc transport, as well as inadequate dosing of or adherence to PERT 70 .…”

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

“…Studies by Dresler et al evaluated serum copper in patients post–total pancreatectomy, and no deficiencies were noted 50 . However, Yasuda et al presented a case study of 1 patient being followed after PD with distal gastrectomy in which the patient had low serum copper—this was corrected with methaphyllin (3 g/d) and initiation and continuation of pancreatic enzyme replacement 69 . In that case as well as one other presented by Yasuda et al, the patients were reported to have deficiency in vitamin B6, which was treated with oral pyridoxal phosphate hydrate and continued or initiated use of PERT 69 .…”

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

“…However, Yasuda et al presented a case study of 1 patient being followed after PD with distal gastrectomy in which the patient had low serum copper—this was corrected with methaphyllin (3 g/d) and initiation and continuation of pancreatic enzyme replacement 69 . In that case as well as one other presented by Yasuda et al, the patients were reported to have deficiency in vitamin B6, which was treated with oral pyridoxal phosphate hydrate and continued or initiated use of PERT 69 . In summary, other micronutrient deficiencies may exist that have not been consistently reported in the literature, but these seem to generally resolve with adequate PERT therapy.…”

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

“…67 Zinc deficiency has been reported following surgery for pancreatic cancer in case reports and small retrospective evaluations. 46,50,[68][69][70] Deficiency is thought to be related to disturbance of zinc absorption in the jejunum as well as poor protein absorption and, therefore, poor zinc transport, as well as inadequate dosing of or adherence to PERT. 70 Yazbeck et al 68 described a single case of a young female patient presenting with symptoms, including alopecia, total body hair loss, dry scaly skin, glossitis, and maculopathy with vision loss.…”

Section: Zincmentioning

confidence: 99%

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Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Petzel

Hoffman

2017

Nut in Clin Prac

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With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease. Beyond causing additional medical problems, each of these can have significant effects on quality of life and functional status. The potential mechanisms, diagnosis criteria, and potential treatments of these conditions are described. Overall, little literature exists to fully describe the effects of these comorbidities, and even less is able to guide effective treatments for this population. Clinicians caring for these patients should begin incorporating goals for promotion of long-term health and reduction of these known and reported comorbidities in patients who have undergone pancreatic surgery. Treatment plans in this population remain understudied, and clinicians may need to consider recommendations for similar disease states when developing interventions for these patients.

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Section: Other Vitamins and Mineralsmentioning

confidence: 71%

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

Section: Other Vitamins and Mineralsmentioning

confidence: 99%

Section: Zincmentioning

confidence: 99%

See 3 more Smart Citations

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Petzel

Hoffman

2017

Nut in Clin Prac

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Anemia after pancreaticoduodenectomy in patients followed‐up for 5 years

Wu,

Kuo,

et al. 2024

J Hepato Biliary Pancreat

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BackgroundAnemia is a common long‐term metabolic sequela caused by anatomical changes after major gastrointestinal surgery, such as bariatric surgery and gastrectomy. Pancreaticoduodenectomy (PD) involves resection of the duodenum and enteral bypass, which may contribute to malabsorption and nutrient deficiency. Hence, PD may cause anemia.MethodsThis study included 322 patients who presented with PD during the 5‐year follow‐up from 2006 to 2017. The Kaplan–Meier method and the Cox regression model were used to investigate the association between risk factors and anemia.ResultsApproximately 44.4% of patients developed post‐PD anemia during the 5‐year post‐PD follow‐up. Further, 30 (9.3%) patients were treated with oral iron supplementation for anemia with associated symptoms. In the Cox multivariate model, a higher Charlson Comorbidity Index (CCI) score and pancreatic ductal adenocarcinoma were significantly associated with the development of post‐PD anemia.ConclusionPost‐PD anemia is a common sequela among long‐term survivors. A higher CCI and pancreatic ductal adenocarcinoma diagnosis were considered as independent risk factors for post‐PD anemia. Therefore, regular monitoring of hematological profiles and appropriate management of post‐PD anemia are required during follow‐up.

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Nutritional neuropathies

Gwathmey

Grogan

2019

Muscle and Nerve

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Neuropathies associated with nutritional deficiencies are routinely encountered by the practicing neurologist. Although these neuropathies assume different patterns, most are length‐dependent, sensory axonopathies. Cobalamin deficiency neuropathy is the exception, often presenting with a non–length‐dependent sensory neuropathy. Patients with cobalamin and copper deficiency neuropathy characteristically have concomitant myelopathy, whereas vitamin E deficiency is uniquely associated with a spinocerebellar syndrome. In contrast to those nutrients for which deficiencies produce neuropathies, pyridoxine toxicity results in a non–length‐dependent sensory neuronopathy. Deficiencies occur in the context of malnutrition, malabsorption, increased nutrient loss (such as with dialysis), autoimmune conditions such as pernicious anemia, and with certain drugs that inhibit nutrient absorption. When promptly identified, therapeutic nutrient supplementation may result in stabilization or improvement of these neuropathies.

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Anemia attributed to vitamin B6 deficiency in post-pancreaticoduodenectomy patients

Cited by 18 publications

References 11 publications

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Anemia after pancreaticoduodenectomy in patients followed‐up for 5 years

Nutritional neuropathies

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