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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| Language: | English |
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SAGE Publishing
2025-05-01
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| 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. |
| format | Article |
| id | doaj-art-c612d9da749e45febbb53baecb397732 |
| institution | OA Journals |
| issn | 2324-7096 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| 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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