The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients

There has been a multivitamin infusion (MVI) shortage for the last decade, generating increasing concerns for the neonatal population. This study evaluated a cohort of 4 total parenteral nutrition (TPN)-dependent neonates who presented within a 6-month period with abnormal biochemistry in a complex...

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Main Authors: Reva Frankel MD, Courtney Verscaj MD, Christina G. Tise MD, PhD, Kristina Cusmano-Ozog MD
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Journal of Investigative Medicine High Impact Case Reports
Online Access:https://doi.org/10.1177/23247096251339303
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author Reva Frankel MD
Courtney Verscaj MD
Christina G. Tise MD, PhD
Kristina Cusmano-Ozog MD
author_facet Reva Frankel MD
Courtney Verscaj MD
Christina G. Tise MD, PhD
Kristina Cusmano-Ozog MD
author_sort Reva Frankel MD
collection DOAJ
description There has been a multivitamin infusion (MVI) shortage for the last decade, generating increasing concerns for the neonatal population. This study evaluated a cohort of 4 total parenteral nutrition (TPN)-dependent neonates who presented within a 6-month period with abnormal biochemistry in a complex and unusual pattern. All exhibited findings were suggestive of multiple inherited metabolic disorders (IMD), particularly multiple acyl-CoA dehydrogenase deficiency and maple syrup urine disease. Given the rarity of having 2 IMDs, communication with the primary team was initiated and revealed inadequate MVI in the administered TPN. All biochemical abnormalities could be explained by thiamine (B1), riboflavin (B2), pyridoxine (B6), and/or biotin (B7) deficiency. MVI-deficient TPN as the single unifying etiology is further supported by normal newborn screening (NBS) and resolution of biochemical abnormalities with MVI administration in all neonates. Awareness of this problem is critical to avoid unnecessary testing and initiate prompt treatment with vitamins.
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spelling doaj-art-c612d9da749e45febbb53baecb3977322025-08-20T02:25:44ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962025-05-011310.1177/23247096251339303The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal PatientsReva Frankel MD0Courtney Verscaj MD1Christina G. Tise MD, PhD2Kristina Cusmano-Ozog MD3Stanford University, CA, USAStanford University, CA, USAStanford University, CA, USAStanford University, CA, USAThere has been a multivitamin infusion (MVI) shortage for the last decade, generating increasing concerns for the neonatal population. This study evaluated a cohort of 4 total parenteral nutrition (TPN)-dependent neonates who presented within a 6-month period with abnormal biochemistry in a complex and unusual pattern. All exhibited findings were suggestive of multiple inherited metabolic disorders (IMD), particularly multiple acyl-CoA dehydrogenase deficiency and maple syrup urine disease. Given the rarity of having 2 IMDs, communication with the primary team was initiated and revealed inadequate MVI in the administered TPN. All biochemical abnormalities could be explained by thiamine (B1), riboflavin (B2), pyridoxine (B6), and/or biotin (B7) deficiency. MVI-deficient TPN as the single unifying etiology is further supported by normal newborn screening (NBS) and resolution of biochemical abnormalities with MVI administration in all neonates. Awareness of this problem is critical to avoid unnecessary testing and initiate prompt treatment with vitamins.https://doi.org/10.1177/23247096251339303
spellingShingle Reva Frankel MD
Courtney Verscaj MD
Christina G. Tise MD, PhD
Kristina Cusmano-Ozog MD
The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
Journal of Investigative Medicine High Impact Case Reports
title The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
title_full The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
title_fullStr The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
title_full_unstemmed The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
title_short The Clinical and Biochemical Impact of the Multivitamin Shortage on Neonatal Patients
title_sort clinical and biochemical impact of the multivitamin shortage on neonatal patients
url https://doi.org/10.1177/23247096251339303
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