Oral vitamin B12 therapy supplementation in patients with ileo-colonic resection for Crohn’s disease

Česká verzia

Authors: Kaštylová K. ¹; Černá K. ¹; Hejnarová J. ²; Valkus M. ²; Lukáš M. ¹
Authors place of work: Klinické a výzkumné centrum pro střevní záněty, Klinické centrum ISCARE a. s. a 1. LF UK v Praze ¹; VIDIA-DIAGNOSTIKA, s. r. o., Praha ²
Published in the journal: Gastroent Hepatol 2022; 76(2): 145-151
Category:
doi: https://doi.org/10.48095/ccgh2022145

Summary

Aim of the study: To verify the efficacy and safety of orally administered vitamin B12 in patients after ileocolic resectionresection for Crohn’s disease. Methods: We compared the total serum levels of vitamin B12 and its active form in 23 patients with Crohn’s disease after ileal resection with low initial cobalamin concentrations after monthly replacement with 19 patients, also with Crohn’s disease after ileal resection with low initial cobalamin concentrations, taking oral vitamin B12 replacement for two months. Results: After 14 days of therapy, both cohorts showed a significant increase in serum levels of total and active forms of vitamin B12. These levels remained stable throughout the duration of oral cyanocobalamin supplementation. In cohort A (therapy for 30 days), there was again a significant decrease in the levels of both analytes at day D61, whereas in cohort B (with therapy lasting 60 days) there was no significant fluctuation in the levels of either of the measured analytes. In the cohort of patients with two months of oral cyanocobalamin supplementation, significantly higher levels of total vitamin B12, but not its active form, were achieved at D61. The Spearman correlation coefficient is r = 0.8081 (p = 0.0001), indicating a good correlation between the dynamics of the rise in total and active vitamin B12. Conclusion: Continuous oral administration of vitamin B12 at a dose of 1,000 μg/day is an effective strategy which quickly normalized and maintained vitamin B12 concentration in patients after ileo-caecal resection for Crohn’s disease.

Keywords:

Crohn’s disease – vitamin B12 – ileo-caecal resection

Zdroje

1. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med 2013; 368 (2): 149–160. doi: 10.1056/NEJMcp1113996.

2. Green R. Vitamin B12 deficiency from the perspective of a practicing of a practicing hematologist. Blood 2017; 129 (19): 2603–2611. doi: 10.1182/blood-2016-10-569186.

3. Combs GF Jr. The vitamins: fundamental aspects in nutrition and health. 1st ed. Burlington: Elsevier Academic Press 2008.

4. Christensen EI, Birn H. Megalin and cubilin: synergistic endocytic receptors in renal proximal tubule. Am J Physiol Renal Physiol 2001; 280 (4): F562–F573. doi: 10.1152/ajprenal.2001.280.4.F5462.

5. Verroust PJ, Christensen EI. Megalin and cubilin – the story of two multipurpose receptors unfolds. Nephrol Dial Transplant 2002; 17 (11): 1867–1871. doi: 10.1093/ndt/17.11. 1867.

6. Gropper SA, Smith JL, Groff JL. Advanced nutrition and human metabolism. 5th ed. Australia: Wadsworth/Cengage Learning 2009.

7. Stipanuk MH. Biochemical, physiological and molecular aspects of human nutrition. 2nd ed. Philadelphia: Saunders 2006.

8. Brozmanová H. Laboratorní metody v terapeutickém monitorování léků. Klin Farmakol Farm 2020; 34 (2): 56–62. doi: 10.36290/far.2020.012.

9. Duerksen DR, Fallows G, Bernstein CN. Vitamin B12 malabsorption in patients with limited ileal resection. Nutrition 2006; 22 (11–12): 1210–1213. doi: 10.1016/j.nut. 2006.08.017.

10. Bolaman Z, Kadikoylu G, Yukselen V et al. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study. Clin Ther 2003; 25 (12): 3124–3134. doi: 10.1016/S0149-2918 (03) 90096-8.

11. Kuzminski AM, Del Giacco EJ, Allen RH et al. Effective treatment of cobalamin deficiency with oral cobalamin. Blood 1998; 92 (4): 1191–1198. doi: 10.1182/blood.V92.4.1191.

12. Takasaki Y, Moriuchi Y, Tsushima H et al. Effectiveness of oral vitamin B12 therapy for pernicious anemia and vitamin B12 deficiency anemia. Rinsho Ketsueki 2002; 42 (3): 165–169.

13. Tugba-Kartal A, Cagla-Mutlu Z. Comparison of sublingual and intramuscular administration of vitamin B12 for the treatment of vitamin B12 deficiency in children. Rev Invest Clin 2021; 72 (6): 380–385. doi: 10.24875/RIC.20000208.

14. Andrés E, Loukili NH, Noel E et al. Effects of oral crystalline cyanocobalamin 1,000 μg/d in the treatment of pernicious anemia: an open-label, prospective study in Ten Patients. Curr Ther Res Clin Exp 2005; 66 (1): 13–22. doi: 10.1016/j. Curtheres.2005.02.001.

15. Chan CQ, Low LL, Lee KH. Oral vitamin B12 replacement for the treatment of pernicious anemia. Front Med 2016; 3: 38. doi: 10.3389/fmed.2016.00038.