Riboflavin deficiency in cystic fibrosis: three case reports

Area of Science:

• Nutritional Science
• Pediatric Medicine
• Genetics

Background:

• Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, often leading to nutritional challenges.
• Vitamin deficiencies are common in CF patients due to malabsorption and increased metabolic demands.
• Riboflavin (vitamin B2) is essential for cellular metabolism and energy production.

Observation:

• Three pediatric patients (aged 2-10 years) with CF presented with angular stomatitis, a clinical sign of riboflavin deficiency.
• Erythrocyte glutathione reductase activity assay confirmed riboflavin deficiency in all three patients.
• Two patients with adequate nutritional status and gastrostomy feeding showed adequate dietary riboflavin intake, suggesting absorption or utilization issues.

Findings:

• This study reports the first cases of clinical riboflavin deficiency in the Cystic Fibrosis population.
• Concurrent deficiencies in thiamin, pyridoxine, and iron were also noted in these patients.
• The findings suggest potential increased requirements, inadequate absorption, or impaired utilization of riboflavin in CF.

Implications:

• The identification of riboflavin deficiency in CF patients necessitates routine screening and monitoring of vitamin B2 status.
• Understanding the underlying mechanisms of riboflavin deficiency in CF may lead to improved management strategies.
• This research underscores the importance of comprehensive nutritional assessment in pediatric CF care.