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Original ArticleOpen Access
Effect of Oral Vitamin E Supplementation in Children with Cholestasis
Roongpraiwan R 
,
Suthutvoravut U ,
Feungpean B ,
Phuapradit P
,
Suthutvoravut U ,
Feungpean B ,
Phuapradit P Objective : Malabsorption and deficiency of vitamin E are common consequences of chronic
cholestasis. The objective of this study was to determine vitamin E status by using plasma vitamin
Eltotal lipid ratio (E/L) in children with cholestasis during supplementation with 20 IU/kg/day and
100 IU/kg/day of oral vitamin E capsule, and 50 IU/kg/day of cold water soluble form (CWS/F) of
vitamin E.
Method : Children with cholestasis who were being supplemented with 20 IU/kg/day of oral
vitamin E capsule (dl-a-tocopherol) were enrolled into this study. After initial evaluation for vitamin
E status and liver function, doses of oral vitamin E supplementation were increased to 100 IU/kg/day
for 1 month. Then, supplementation was switched to 50 IU/kg/day of CWS/F vitamin E for 1 month.
Vitamin E status was assessed by using plasma ElL after each period of supplementation.
Results : Eleven children with biliary atresia, aged between 2 and 18 months, were studied.
Their median weight standard deviation score (SDS) was -1.35 and median height SDS was -1.26.
The medians of serum direct bilirubin and total bilirubin were 6.5 and 12.9 mg/dl, respectively. Only
2 and 3 out of 9 children had plasma ElL above normal cut-off levels during supplementation with
20 and 100 IU/kg/day of vitamin E capsule, respectively. Additionally, 4 of 9 children had plasma
E/L above normal cut-off level after one month's supplementation with 50 IU/kg/day of CWS/F
vitamin E. All the responders had serum bilirubin levels less than 4 mg/dl while the remainder with
serum direct bilirubin level more than 4 mg/dl had their plasma E/L below normal cut-off levels in
spite of any vitamin E supplementation.
Conclusion : Oral vitamin E supplementation with 20 IU/kg/day and 100 IU/kg/day of
vitamin E capsule and with 50 IU/kg/day of CWS/F vitamin E were able to normalize vitamin E
status in a few cholestatic children who had serum direct bilirubin levels less them 4 mg/dl. In cases
of serum direct bilirubin more than 4 mg/dl, neither of vitamin E supplementations was able to correct
the vitamin E deficiency status.
Key word : Oral Vitamin E Supplementation, Cholestasis
cholestasis. The objective of this study was to determine vitamin E status by using plasma vitamin
Eltotal lipid ratio (E/L) in children with cholestasis during supplementation with 20 IU/kg/day and
100 IU/kg/day of oral vitamin E capsule, and 50 IU/kg/day of cold water soluble form (CWS/F) of
vitamin E.
Method : Children with cholestasis who were being supplemented with 20 IU/kg/day of oral
vitamin E capsule (dl-a-tocopherol) were enrolled into this study. After initial evaluation for vitamin
E status and liver function, doses of oral vitamin E supplementation were increased to 100 IU/kg/day
for 1 month. Then, supplementation was switched to 50 IU/kg/day of CWS/F vitamin E for 1 month.
Vitamin E status was assessed by using plasma ElL after each period of supplementation.
Results : Eleven children with biliary atresia, aged between 2 and 18 months, were studied.
Their median weight standard deviation score (SDS) was -1.35 and median height SDS was -1.26.
The medians of serum direct bilirubin and total bilirubin were 6.5 and 12.9 mg/dl, respectively. Only
2 and 3 out of 9 children had plasma ElL above normal cut-off levels during supplementation with
20 and 100 IU/kg/day of vitamin E capsule, respectively. Additionally, 4 of 9 children had plasma
E/L above normal cut-off level after one month's supplementation with 50 IU/kg/day of CWS/F
vitamin E. All the responders had serum bilirubin levels less than 4 mg/dl while the remainder with
serum direct bilirubin level more than 4 mg/dl had their plasma E/L below normal cut-off levels in
spite of any vitamin E supplementation.
Conclusion : Oral vitamin E supplementation with 20 IU/kg/day and 100 IU/kg/day of
vitamin E capsule and with 50 IU/kg/day of CWS/F vitamin E were able to normalize vitamin E
status in a few cholestatic children who had serum direct bilirubin levels less them 4 mg/dl. In cases
of serum direct bilirubin more than 4 mg/dl, neither of vitamin E supplementations was able to correct
the vitamin E deficiency status.
Key word : Oral Vitamin E Supplementation, Cholestasis
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