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Prevalence and factors associated with vitamin C deficiency in inflammatory bowel disease

World Journal of Gastroenterology 2022年第33期28卷 4834-4845页

作者： Benjamin Langan Gordon Jonathan S Galati Stevie Yang Randy S Longman Dana Lukin ellen J scherl Robert Battat Department of Medicine New York Presbyterian/Weill Cornell Medical CenterNew YorkNY 10065United States Department of Gastroenterology and Hepatology New York Presbyterian/Weill Cornell Medical CenterNew YorkNY 10021United States

BACKGROUND Patients with inflammatory bowel disease(IBD) are prone to several nutritional deficiencies. However, data are lacking on vitamin C deficiency in Crohn’s disease(CD) and ulcerative colitis(UC) patients, as well as the impact of clinical, biomarker and endoscopic disease severity on the development of vitamin C *** To determine proportions and factors associated with vitamin C deficiency in CD and UC *** In this retrospective study, we obtained clinical, laboratory and endoscopic data from CD and UC patients presenting to the IBD clinic at a single tertiary care center from 2014 to 2019. All patients had an available plasma vitamin C level. Of 353 subjects who met initial search criteria using a cohort discovery tool, 301ultimately met criteria for inclusion in the study. The primary aim described vitamin C deficiency(≤ 11.4 μmol/L) rates in IBD. Secondary analyses compared proportions with deficiency between active and inactive IBD. Multivariate logistic regression analysis evaluated factors associated with *** Of 301 IBD patients, 21.6% had deficiency, including 24.4% of CD patients and 16.0% of UC patients. Patients with elevated C-reactive protein(CRP)(39.1% vs 16.9%, P < 0.001) and fecal calprotectin(50.0% vs 20.0%, P = 0.009) had significantly higher proportions of deficiency compared to those without. Penetrating disease(P = 0.03),obesity(P = 0.02) and current biologic use(P = 0.006) were also associated with deficiency on univariate analysis. On multivariate analysis, the objective inflammatory marker utilized for analysis(elevated CRP) was the only factor associated with deficiency(odds ratio = 3.1, 95%confidence interval: 1.5-6.6, P = 0.003). There was no difference in the presence of clinical symptoms of scurvy in those with vitamin C deficiency and those *** Vitamin C deficiency was common in IBD. Patients with elevated inflammatory markers and penetrating disease had higher rates of vitamin

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Vitamin C deficiency Scurvy Malnutrition

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The JAK2<sup>V617F</sup>Mutation Seen in Myeloproliferative Neoplasms (MPNs) Occurs in Patients with Inflammatory Bowel Disease: Implications of a Pilot Study

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International Journal of Clinical Medicine 2013年第12期4卷 10-15页

作者： Emil Kuriakose Elena Lascu Y. Lynn Wang Stefani Gjoni Nicholas C. P. Cross Ruth Baumann Kerilee Tam ellen scherl Randy S. Longman Richard T. Silver Department of Pathology University of Chicago Chicago USA Division of Hematology and Medical Oncology Weill Cornell Medical College New York USA Jill Roberts Center for Inflammatory Bowel Disease Division of Gastroenterology Weill Cornell Medical College New York USA Wessex Regional Genetics Laboratory Salisbury District Hospital University of Southampton Salisbury UK

Patients with IBD frequently have hematologic abnormalities suggestive of JAK2 mutated MPNs, but are traditionally classified as reactive processes. Haplotype 46/1 is a well-characterized genetic predisposition, common to both inflammatory bowel disease (IBD) and myeloproliferative neoplasms (MPN). In view of this shared genetic predisposition, we measured the frequency of the JAK2V617F mutation in IBD patients with thrombocytosis or erythrocytosis, in order to ascertain whether a higher than expected proportion of these patients may in fact have underlying MPNs. 1121 patients were identified with an active diagnosis of Crohn’s disease or ulcerative colitis, of which 474 had either thrombocytosis or erythrocytosis. Patients with abnormal counts were tested for the JAK2V617F mutation during routine follow-up visits. Interim analysis of first 23 patients tested was performed to assess whether the JAK2V617F positivity rate was statistically significant compared with known expected frequencies in a comparable control population. Of 23 patients, 13 patients had thrombocytosis and 10 had erythrocytosis. Three patients with thrombocytosis (23%), and 1 patient with erythrocytosis (10%), tested positive for JAK2V617F, exceeding the expected thresholds for statistical significance. In patients with IBD and thrombocytosis or erythrocytosis, a meaningful proportion may harbor an undiagnosed MPN, as indicated by clonal abnormalities such as JAK2V617F. These findings imply the need for increased testing of these patients for clonal hematologic abnormalities, and importantly, if found, suggest the need for therapeutic strategies with drugs, such as JAK2 inhibitors, in patients with both MPN and IBD.

关键词： JAK2V617F Myeloproliferative Neoplasms Inflammatory Bowel Disease Thrombocythemia Polycythemia

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