title: Is oral vitamin B(12) therapy effective for vitamin B(12) deficiency in patients with prior ileocystoplasty?
abstract: OBJECTIVE
  We previously identified vitamin B(12) deficiency as a potential long-term consequence in pediatric patients with prior ileocystoplasty despite adequate preservation of terminal ileum. Vitamin B(12) deficiency can result in hematological and neurological deficits, of which some are irreversible. Deficiency discovered after ileocystoplasty is purportedly due to B(12) malabsorption since the principal absorption site is ileum. B(12) deficiency due to malabsorption is typically treated with intramuscular injection to ensure adequate treatment. We determined whether oral vitamin B(12) supplementation could increase serum vitamin B(12) in patients with deficiency who underwent ileocystoplasty.
  
  
  METHODS
  During followup after ileocystoplasty we identified patients with low (200 pg/dl or less) or low normal (200 to 300 pg/dl) vitamin B(12). Oral vitamin B(12) was begun at 250 μg. Serum B(12) was assessed at 1, 2 and 3-month intervals after beginning therapy.
  
  
  RESULTS
  A total of 128 patients with a mean followup of 83 months after ileocystoplasty had vitamin B(12) levels available for review. Of these patients 36 (28%) had a level of 300 pg/dl or less with a level of 200 pg/dl or less in 16 (13%). After oral vitamin B(12) treatment serum levels increased from a mean 235 to 506 pg/dl (114%) upon initial measurement (p <0.001). Subsequent measurements continued to increase from the first posttreatment level (p <0.05). No adverse effects were noted during a mean 4-month followup.
  
  
  CONCLUSIONS
  To our knowledge this is the first study to show that oral vitamin B(12) effectively increases serum levels in pediatric patients with prior ileocystoplasty.
authors: Department of Urology, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana 46202, USA. vanderbb@iupui.edu
authors: Brian A
authors: BA
authors: Vanderbrink
authors: Mark P
authors: MP
authors: Cain
authors: Shelly
authors: S
authors: King
authors: Kirstan
authors: K
authors: Meldrum
authors: Martin
authors: M
authors: Kaefer
authors: Rosalia
authors: R
authors: Misseri
authors: Deanna
authors: D
authors: Jones
authors: Richard C
authors: RC
authors: Rink
mesh_terms: D000284:Administration, Oral; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy* / Q000209:etiology*; D014803:Vitamin B Complex / Q000008:administration & dosage*
chemical_list: D014803:Vitamin B Complex; D014805:Vitamin B 12