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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of vitamin E in human nutrition was studied by investigation of patients with cystic fibrosis (CF) and associated pancreatic insufficiency. Vitamin E status was assessed by measurement of the plasma concentration of the principal circulating isomer, alpha-tocopherol. Results of such determinations in 52 CF patients with pancreatogenic steatorrhea revealed that all were deficient in the vitamin. The extent of decreased plasma tocopherol varied markedly but correlated with indices of intestinal malabsorption, such as the serum carotene concentration and percentage of dietary fat absorbed. Supplementation with 5-10 times the recommended daily allowance of vitamin E in a water-miscible form increased the plasma alpha-tocopherol concentrations to normal in all 19 CF patients so evaluated. Studies on the effects of vitamin E deficiency focused on possible hematologic alterations. An improved technique was developed to measure erythrocyte hemolysis in vitro in the presence of hydrogen peroxide. While erythrocyte suspensions from control subjects demonstrated resistance to hemolysis during a 3-h incubation, all samples from tocopherol-deficient CF patients showed abnormal oxidant susceptibility, evidenced by greater than 5% hemoglobin release. The degree of peroxide-induced hemolysis was related to the plasma alpha-tocopherol concentration in an inverse, sigmoidal manner. The possibility of in vivo hemolysis was assessed by measuring the survival of (51)Cr-labeled erythrocytes in 19 vitamin-E deficient patients. A moderate but statistically significant decrease in the mean (51)Cr erythrocyte half-life value was found in this group. Measurement of erythrocyte survival before and after supplementation of 6 patients with vitamin E demonstrated that the shortened erythrocyte lifespan could be corrected to normal with this treatment. Other hematologic indices in deficient subjects, however, were normal and did not change upon supplementation with vitamin E. It is concluded that CF is invariably associated with vitamin E deficiency, provided that the patient in question has pancreatic achylia and is not taking supplementary doses of tocopherol. Concomitant hematologic effects consistent with mild hemolysis, but not anemia, occur and may be reversed with vitamin E therapy. Patients with CF should be given daily doses of a water-miscible form of vitamin E to correct the deficiency.
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PMID:The occurrence and effects of human vitamin E deficiency. A study in patients with cystic fibrosis. 87 86

The unique association of idiopathic diffuse membranous nephropathy and micro-angiopathic haemolytic anaemia and thrombocytopenia is described. A 7 year old Vietnamese boy with a 1-month history of anaemia resistant to oral iron supplements presented with acute onset of nephrotic syndrome. Investigations revealed a micro-angiopathic haemolytic anaemia and thrombocytopenia. There was no associated oliguria or uraemia. Diffuse membranous nephropathy was diagnosed by renal biopsy. Apart from a fourfold rise in enterovirus titres, no underlying cause for the haematological or glomerular abnormalities was found. There was an apparent, partial haematological response to fresh frozen plasma infusions, but not to Vitamin E.
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PMID:Micro-angiopathic haemolysis, thrombocytopenia and nephrotic syndrome associated with membranous nephropathy in a Vietnamese boy. 322

Serum vitamin E levels are reduced in newborn infants. It has been reported that this deficiency is responsible, in part, for the development of anemia in premature infants during the first 6 weeks of life. The efficacy of vitamin E supplementation for the prevention of anemia in premature infants has been studied in a randomized, controlled, and blinded trial. Premature infants whose birth weights were less than 1,500 g were given, by gavage, 25 IU of dl-alpha-tocopherol or a similar volume of the drug vehicle. Treatment was continued for the first 6 weeks of life. A total of 178 infants were studied. Vitamin E levels were significantly higher in a supplemented group by day 3 and for the remainder of the 6-week period. At 6 weeks of age, there was no significant difference between the supplemented and unsupplemented groups in hemoglobin concentration, reticulocyte and platelet counts, or erythrocyte morphology. It is concluded that there is no evidence to support a policy of administering vitamin E to premature infants to prevent the anemia of prematurity.
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PMID:Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial. 354 Aug 36

Early administration of vitamin E to low birth weight (less than 1500 g) infants results in alleviation of the symptoms of retinopathy of prematurity and a lowered incidence of intraventricular hemorrhage. If vitamin E is given to children with cholestatic liver disease (orally or parenterally) before 3 years of age, neurological symptoms such as areflexia, ataxia, and sensory neuropathy are prevented or reversed. Restitution of neurological function is more limited in children ages 5-17 years even after prolonged therapy. Vitamin E is also useful in prevention of neuropathy and retinopathy associated with abetalipoproteinemia and cystic fibrosis. Blood levels of tocopherol are often low in subjects with hemolytic anemias. Administration of vitamin E to G-6-P-D-deficient subjects increased hemoglobin levels, and decreased the number of irreversibly sickled cells in sickle-cell anemia subjects. Most trials have indicated that administration of vitamin E for 6 months or more to subjects with intermittent claudication results in longer walking distance and improved blood flow. Vitamin E reduces platelet aggregation, platelet adhesion to collagen, and platelet thromboxane production. Prostacyclin production is generally enhanced. The significance of these effects to thrombotic diseases. Epidemiological studies have indicated that subjects with higher blood levels of vitamin E have lower risk of death from ischemic heart disease and cancer, a lower risk of breast cancer, and a lower incidence of infections.
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PMID:Clinical uses of vitamin E. 391 44

Certain owl monkeys (AOT) develop spontaneous hemolytic anemia that responds to vitamin E. The anemia is associated with red blood cell lipid peroxidation and altered red blood cell membrane lipid composition. To investigate these changes, plasma lipid and lipoprotein profiles were characterized in anemic, anemia-susceptible, and anemia-resistant AOT. The plasma vitamin E and vitamin A concentrations were assessed as an index of fat absorption and the effect of corn oil supplementation and vitamin E-selenium injection were measured. Anemia-susceptible AOT had depressed plasma levels of vitamin E and A and an altered lipoprotein metabolism characterized by elevated ratios of low/high density lipoprotein cholesterol and free to esterified cholesterol in these lipoproteins. Vitamin E-selenium injection in anemia-susceptible AOT increased the plasma vitamin E, and vitamin E and corn oil supplements reduced the high density lipoprotein free to esterified cholesterol ratio. The data suggest that the AOT suffer from fat malabsorption and that the consequences (including tocopherol deficiency) result in altered cholesterol metabolism.
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PMID:Altered lipoprotein metabolism in spontaneous vitamin E deficiency of owl monkeys. 641 97

Vitamin E (alpha-tocopherol) has been credited with a variety of beneficial effects in the premature newborn infant. It has been thought that deficiency of vitamin E is at least partly responsible for the anemia which often occurs 4 to 6 wk after premature birth, and routine dietary supplementation with vitamin E is frequently recommended. However, critical analysis reveals that published controlled studies of vitamin E supplementation do not agree on the magnitude or even the existence of this protective effect against anemia. Analysis of commonly used feeding practices suggests that the dietary ratio of alpha-tocopherol to polyunsaturated fatty acids is generally sufficient to prevent manifestations of vitamin E deficiency without supplementation. Large parenteral doses of vitamin E have been purported to protect premature infants exposed to oxygen-enriched environments and mechanical ventilation from the complications of retrolental fibroplasia and bronchopulmonary dysplasia. Subsequent studies, however, have not yet substantiated encouraging early reports of these protective effects. At present, there seems to be no clearly established need for supplementing the premature infant's usual dietary intake of vitamin E.
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PMID:The role of vitamin E in the nutrition of premature infants. 678 56

Significant alterations in hemotologic function in cystic fibrosis are suggested by the observation that polycythemia is uncommon, even among cyanotic patients. To elucidate those factors that influence hematologic equilibrium, 39 stable patients with cystic fibrosis were evaluated with regard to hemoglobin, hematocrit, RBC indices, reticulocyte count, serum iron and total iron binding capacity, serum ferritin, vitamin E, and carboxyhemoglobin levels. Hemoglobin concentrations were below the 50th percentile for age in 90% of the patients, including the 23% who were cyanotic. Serum ferritin levels were below the mean for age in 85% and below 12 ng/mL in 33% of patients. Vitamin E levels were less than 5 micrograms/dL in 33%, indicating deficiency. Carboxyhemoglobin values were elevated in 64% of the patients. These data indicate that relative anemia is common in cystic fibrosis and suggest that iron and vitamin E deficiency may contribute to that anemia. Twenty-two patients with cystic fibrosis were then given 2 weeks of oral iron therapy followed by two to three additional weeks of iron and vitamin E. This therapeutic trial resulted in an increase in mean hemoglobin concentration from 13.87 to 14.50 g/dL (P less than 0.01) associated with a significant increase in levels of serum ferritin (P less than 0.001). The increase in hemoglobin occurred primarily during the second 2 weeks when patients were receiving both iron and vitamin E. However, we were unable to document evidence of increased hemolysis when patients were receiving iron therapy alone. This response to oral iron therapy is confirmation that iron deficiency contributes to the failure of some patients with cystic fibrosis to compensate hemotologically for hypoxia.
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PMID:Relative anemia and iron deficiency in cystic fibrosis. 683 67

Dapsone (4,4'diaminodiphenyl-sulphone) commonly used in the treatment of patients who suffer from leprosy, is a strongly oxidative drug, producing damage to the red cell membrane. This study investigated whether Vitamin E would have a protective effect on the red cell membrane from oxidant damage caused by Dapsone in patients with leprosy. We have studied 16 patients for 4 months, divided into two groups. Group 1 (n = 7) dapsone (DDS): 100 mg/day; Group 2 (n = 9) dapsone: 100 mg/day in addition with Vitamin E: 800 U/day. We did not include patients with low levels of Glucose-6-Phosphate Dehydrogenase (G-6-PD) because of their sensibility to this drug. At the beginning of the treatment we determined the level of G-6-PD. All patients showed a normocytic normochromic anemia with a decrease in Haptoglobine levels (below 5 mg/dl). Statistical analyses showed that reticulocyte counts did not present significant differences between groups all through evolution. As for methemoglobin (Hi) we observed in Group 1 an increase between the first and the fourth month, which was not seen in group 2. Statistical analyses of the results suggest that oral Vitamin E confers partial protective effect and does not correct the hemolysis parameters produced by Dapsone treatment except for Hi levels which were more sensitive to the oxidant damage.
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PMID:[Vitamin E as protective agent against hemolysis in leprosy patients under dapsone treatment]. 953 24

In order to determine the role of correcting anaemia with r-HuEPO on susceptibility of red cell to lipid peroxidation, 15 patients on maintenance haemodialysis treated with r-HuEPO for at least one year (group I), 15 patients on maintenance haemodialysis without r-HuEPO (group II) and 30 persons as a control group (group III) were included in the study. We measured erythrocyte superoxide dismutase (e-SOD), erythrocyte catalase (e-CAT) activities, plasma malonyldialdehyde (p-MDA) and serum vitamin E levels in all patients. The healthy controls (group III) had significantly lower levels of p-MDA in comparison to those measured in haemodialysed patients (group I-II) (p < 0.0001). e-SOD activity in group III was significantly higher than in groups I and II, respectively (p < 0.0001 and p < 0.00001), and e-SOD activity was significantly lower in group II than in group I (p < 0.0001). e-CAT activity in group III was higher than in groups I and II, respectively (p < 0.0001 and p < 0.00001) and it was significantly lower in group II than in group I (p < 0.0001). Vitamin E concentration in group III was lower than in group I and group II, respectively (p < 0.0001 and p < 0.0001). But there is no difference between groups I and II. This study suggests that r-HuEPO therapy improves anaemia by decreasing lipid peroxidation and increasing antioxidant activity.
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PMID:Red cell lipid peroxidation and antioxidant system in haemodialysed patients: influence of recombinant human erythropoietin (r-HuEPO) treatment. 982 Oct 56

The efficacy of combined therapy with recombinant human erythropoietin (rhEPO) and vitamin E versus rhEPO alone in the treatment of anemia was examined in children (n = 10, aged 15.2 +/- 3.2 years) on chronic hemodialysis at the restart of rhEPO therapy after a 4-week interval. The results confirmed that rhEPO induced oxidative stress of the red blood cells as observed during the first rhEPO therapy. Vitamin E (15 mg/kg per day per os) was introduced after 2 weeks of rhEPO monotherapy, when the signs of acute oxidative stress appeared. The level of oxidized glutathione (GSSG) increased from 8.9 +/- 3.1 to 26.7 +/- 5.7 nmol/g hemoglobin (Hb) by that time. After 2 weeks of simultaneous vitamin E treatment, there was a significant difference in GSSG values compared with rhEPO monotherapy (10.1 +/- 3.9 vs. 56.7 +/- 15.8 nmol/g Hb, P < 0.001). A considerable decrease was observed in the previously high ratio of GSSG/reduced glutathione (GSH), an indicator of oxidative stress, and the level of carboxyhemoglobin, indicating hemolysis. A significant increase in Hb and hematocrit (P < 0.01) was achieved within 2 weeks of starting the combined therapy, while similar results occurred only at the 8th and 5th weeks without vitamin E. Antioxidant vitamin E supplementation improved the therapeutic effect of rhEPO in patients with chronic renal failure on hemodialysis.
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PMID:Vitamin E alleviates the oxidative stress of erythropoietin in uremic children on hemodialysis. 1065 22


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