{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:20:55Z","timestamp":1789230055170,"version":"build-2803163510"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>Cholestasis predisposes to fat-soluble vitamin (FSV) deficiencies. A liquid multiple FSV preparation made with tocopheryl polyethylene glycol-1000 succinate (TPGS) is frequently used in infants with biliary atresia (BA) because of ease of administration and presumed efficacy. In this prospective multicenter study, we assessed the prevalence of FSV deficiency in infants with BA who received this FSV\/TPGS preparation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Infants received FSV\/TPGS coadministered with additional vitamin K as routine clinical care in a randomized double-blinded, placebo-controlled trial of corticosteroid therapy after hepatoportoenterostomy (HPE) for BA (identifier NCT 00294684). Levels of FSV, retinol binding protein, total serum lipids, and total bilirubin (TB) were measured 1, 3, and 6 months after HPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Ninety-two infants with BA were enrolled in this study. Biochemical evidence of FSV insufficiency was common at all time points for vitamin A (29%\u201336% of patients), vitamin D (21%\u201337%), vitamin K (10%\u201322%), and vitamin E (16%\u201318%). Vitamin levels were inversely correlated with serum TB levels. Biochemical FSV insufficiency was much more common (15%\u2013100% for the different vitamins) in infants whose TB was \u22652 mg\/dL. At 3 and 6 months post HPE, only 3 of 24 and 0 of 23 infants, respectively, with TB &amp;gt;2 mg\/dL were sufficient in all FSV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Biochemical FSV insufficiency is commonly observed in infants with BA and persistent cholestasis despite administration of a TPGS containing liquid multiple FSV preparation. Individual vitamin supplementation and careful monitoring are warranted in infants with BA, especially those with TB &amp;gt;2 mg\/dL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2011-1423","type":"journal-article","created":{"date-parts":[[2012,8,13]],"date-time":"2012-08-13T22:43:12Z","timestamp":1344897792000},"page":"e607-e614","source":"Crossref","is-referenced-by-count":98,"title":["Efficacy of Fat-Soluble Vitamin Supplementation in Infants With Biliary Atresia"],"prefix":"10.1542","volume":"130","author":[{"given":"Benjamin L.","family":"Shneider","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital Pittsburgh of UPMC, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Haber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul J.","family":"Karpen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hospital, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trivellore","family":"Raghunathan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Francisco, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick J.","family":"Suchy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine and Children\u2019s Hospital Colorado, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanda","family":"Kerkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mount Sinai School of Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumirle","family":"Turmelle","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Washington University, St. Louis, 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