Vitamin status in patients undergoing single or multiple plasmapheresis

Area of Science:

• Nutritional Biochemistry
• Clinical Medicine
• Hematology

Background:

• Plasma exchange (plasmapheresis) is a medical procedure involving the removal of blood plasma.
• The impact of plasmapheresis on vitamin levels, particularly fat-soluble and water-soluble vitamins, requires detailed investigation.
• Understanding these changes is crucial for managing patients undergoing this therapy.

Purpose of the Study:

• To investigate the effects of plasma exchange on a comprehensive panel of vitamins.
• To determine which specific vitamins are significantly altered following acute and chronic plasmapheresis treatments.

Main Methods:

• Vitamins including folate, thiamin, nicotinate, biotin, riboflavin, pantothenate, and vitamins A, B6, B12, C, E, and beta-carotene were quantified.
• Vitamin levels were measured in eight patients before and after a single plasma exchange session.
• Additional measurements were taken in one patient after five consecutive treatments and in three patients 2-8 weeks post-plasmapheresis.

Main Results:

• Significant reductions in vitamin B12, beta-carotene, vitamin B6, vitamin A, vitamin C, and vitamin E were observed after plasmapheresis.
• Concentrations of folate, thiamin, nicotinate, biotin, riboflavin, and pantothenate remained largely unchanged following a single plasma exchange.

Conclusions:

• Acute and chronic plasma exchange can lead to the depletion of several key vitamins, including fat-soluble vitamins and vitamin B12.
• Certain B vitamins (folate, thiamin, nicotinate, biotin, riboflavin, pantothenate) appear to be less affected by plasma exchange.
• Further research is warranted to assess the clinical implications of these vitamin depletions and to develop potential supplementation strategies.