Ileal Enterocystoplasty and B12 Deficiency in Pediatric Patients

Rosenbaum, David; Cain, Mark P.; Kaefer, Martin; Meldrum, Kirstan K.; King, Shelly; Misseri, Rosalia; Rink, Richard C.

doi:10.1016/j.juro.2007.11.089

Cited by 43 publications

(20 citation statements)

References 12 publications

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“…A low vitamin B 12 level was defined as ,300 pg/mL. [1][2][3][4] An ABX Pentra 120 (Horiba) device was used for the blood count, and a Roche E-601 analyzer was used for the detection of vitamin B 12 levels.…”

Section: Methodsmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome (POTS) and Vitamin B12 Deficiency in Adolescents

et al. 2014

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OBJECTIVE: Vitamin B12 is involved in the production of adrenaline from noradrenaline. It is the cofactor involved in catecholamine degradation and plays a role in myelin synthesis. The current study aimed to investigate the association between vitamin B12 levels and postural orthostatic tachycardia syndrome (POTS) during adolescence when accelerated myelin synthesis increases the vitamin B12 need. METHODS: One hundred twenty-five patients (mean age 11.1 ± 2.3 years; 60% female) reporting short-term loss of consciousness and diagnosed with vasovagal syncope based on anamnesis with a normal distribution and 50 control subjects (mean age 10.94 ± 2.5 years, 62% female) were included in this study. Serum vitamin B12, folic acid, and ferritin levels were measured prospectively in addition to other tests. We defined vitamin B12 deficiency as a serum level <300 pg/mL.1–4 RESULTS: Vitamin B12 levels were significantly lower in the patient group compared with the control group (47.2% vs 18%, P < .001). In the patient group, children with the POTS pattern had significantly lower vitamin B12 levels compared with children without the POTS response (P = .03). CONCLUSIONS: Vitamin B12 deficiency in patients with POTS may lead to sympathetic nervous system baroreceptor dysfunction.

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Section: Methodsmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome (POTS) and Vitamin B12 Deficiency in Adolescents

et al. 2014

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“…Patients with hypocobalaminemia may present with pernicious anemia, characterized by megaloblastic anemia, gastrointestinal symptoms, and potentially irreversible neurological symptoms including peripheral neuropathy, loss of positional and vibrational sense, ataxia, seizures, and dementia (58,59). The risk of hypocobalaminemia is thought to increase approximately 5 years after augmentation and continues to escalate over time (60,61).…”

Section: Vitamin B12 Deficiencymentioning

confidence: 99%

Long-Term Sequela of Pediatric Bladder Reconstruction

Roth

Keenan

Cain

et al. 2015

Curr Bladder Dysfunct Rep

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Children with refractory neurogenic bladder (NGB) who have failed maximal medical management are presented with options for bladder reconstruction. It is critical to understand the long-term sequela of bladder augmentation and bladder neck reconstruction to properly counsel families regarding these procedures. Benefits may include preservation of renal function, continence, reduced risk of renal-related mortality and potential improvements in quality of life (QOL). However, these advantages must be balanced with the risks of bladder calculi, perforation, need for additional surgery, acid/base disturbances, vitamin B12 deficiency and malignancy. Therefore, careful patient selection and preoperative counseling are paramount for those undergoing bladder reconstruction which includes intestinal bladder augmentation, as these patients require lifelong vigilant follow-up. IntroductionChildren with neurogenic bladders (NGB) are initially managed with clean intermittent catheterization (CIC) and anticholinergic medications in order to maintain a sizable, continent, and compliant urinary reservoir. Despite early and aggressive intervention, some patients undergo lower urinary tract reconstruction (bladder augmentation, catheterizable channel and/or bladder neck reconstruction) to protect their upper tracts and achieve continence. In a few select patients with favorable urodynamics (UDS) and low outlet resistance, a bladder neck procedure (BNP) can be performed without bladder augmentation to achieve continence. Myelodysplasia, specifically spina bifida (SB), remains the most common etiology of NGB in the pediatric population. Due to medical advances, particularly in the realm of Urology, more SB patients with bladder reconstruction are surviving into adulthood. We review current literature regarding long-term sequela of bladder reconstruction in pediatric patients with neurogenic bladder, with a primary focus on bladder augmentations for refractory NGB secondary to SB.

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“…They recommended vitamin B12 replacement for patients losing more than 50 cm of terminal ileum starting 1 year after surgery. Rosenbaum et al [18] found that pediatric patients who had undergone ileal enterocystoplasty were at the highest risk of developing vitamin B12 deficiency 7 years postoperatively, and that the risk increased with time. They recommended an annual serum vitamin B12 value in children beginning 5 years postoperatively.…”

Section: Ileum and Colonmentioning

confidence: 99%

Augmentation Cystoplasty

Smith

Kobashi

2010

Curr Bladder Dysfunct Rep

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Although more conservative measures are used as first-line treatment of patients with overactive bladder and for those with small capacity, low-compliance bladders, augmentation cystoplasty remains an essential tool for patients who fail conservative therapy. The goal of augmentation cystoplasty is to provide a low-pressure reservoir with adequate capacity while preserving urinary continence and renal function.

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Ileal Enterocystoplasty and B12 Deficiency in Pediatric Patients

Cited by 43 publications

References 12 publications

Postural Orthostatic Tachycardia Syndrome (POTS) and Vitamin B12 Deficiency in Adolescents

Postural Orthostatic Tachycardia Syndrome (POTS) and Vitamin B12 Deficiency in Adolescents

Long-Term Sequela of Pediatric Bladder Reconstruction

Augmentation Cystoplasty

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