{
  "abstract": "The aim of our study was to evaluate the prevalence of iron, folate trace element, and vitamin deficiencies in children with intestinal failure, (IF) on long-term Parenteral Nutrition at home (HPN) and see if there were any differences in deficient levels according to the underlying IF diagnosis. Patients were divided into those with short bowel syndrome (SBS), intestinal motility disorders, and enteropathies.We collected data from our hospital’s electronic records. We identified all children who were well established on HPN for at least 6 months prior to the study and remained on PN for the study period from September 2024 to September 2025. PN was prescribed and monitored according to 2018 ESPGHAN guidelines.1 We retrospectively reviewed the 34 children identified. Diagnoses were motility disorders (n = 18), SBS (n = 14), enteropathies (n = 2). All laboratory results for iron, zinc, selenium, copper, vitamins A, D, E, B12, and folate (taken when C-reactive protein, CRP normal) were obtained over the 12 month period and the mean values were calculated. Levels within 10% of the laboratory reference range were considered insufficient and >10% below deficient.We found that 33/34 patients had results checked at least 4-6 monthly and one patient less often. 77/306, 25% mean levels were low over the 12-month period with 30 insufficient levels and 47 deficient levels. The most frequent low levels were vitamin D (11, 61% motility and 9, 61% SBS), zinc (10, 55% motility; 6, 43% SBS) copper (8, 44% motility; 6, 43% SBS), vitamin A (6, 33% motility; 6, 43% SBS) and iron (6, 33% mot; 3, 21% SBS). Folate, Vitamin B12 and vitamin E(apart from one child) were consistently within or above the normal range. There were no statistically significant differences between SBS and motility patient micronutrient levels. Please see figure 1 below.We conclude that current ESPGHAN recommendations for micronutrient level monitoring are appropriate for detecting deficient levels. Our results indicate that the current guidelines for adding vitamin E, selenium, vitamin B12 and folate to PN are adequate. The high frequency of low levels of zinc, copper, vitamin D and iron indicate that higher amounts may be needed in certain children, probably those with high intestinal losses.Reference Domellöf M, Shamir R, Braegger C, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Iron and trace minerals. Clin Nutr. 2018;37:2354-9.Abstract OC13 Figure 1Abstract OC13 Table 1MicronutrientMotility Deficiency (%)SBS Deficiency (%)Motility Insufficiency (%)SBS Insufficiency (%)Iron33.33% (6/18)21.43% (3/14)0.00% (0/18)0.00% (0/14)Zinc16.67% (3/18)28.57% (4/14)38.89% (7/18)14.29% (2/14)Selenium5.56% (1/18)7.14% (1/14)0.00% (0/18)7.14% (1/14)Vitamin A22.22% (4/18)21.43% (3/14)11.11% (2/18)21.43% (3/14)Vitamin D50.00% (9/18)42.86% (6/14)11.11% (2/18)21.43% (3/14)Folate0.00% (0/18)0.00% (0/14)0.00% (0/18)0.00% (0/14)Vitamin E0.00% (0/18)0.00% (0/14)0.00% (0/18)7.14% (1/14)Vitamin B120.00% (0/18)0.00% (0/14)0.00% (0/18)0.00% (0/14)Copper22.22% (4/18)14.29% (2/14)22.22% (4/18)28.57% (4/14)",
  "authors": [
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Aqsa Ahmed"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Wimalika Don Philip Muhandirumge"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Sarah Khweir"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Jaini Shah"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Dominika Gayda-Pimlott"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Venetia Simchowitz"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Rulla Al-Araji"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Jutta Koeglmeier"
    },
    {
      "affiliations": [
        "Great Ormond Street Hospital for Children NHS Foundation Trust"
      ],
      "name": "Susan Hill"
    }
  ],
  "title": "OC13 Micronutrient levels in children with intestinal failure (IF) on treatment with longterm/home parenteral nutrition (HPN)",
  "uid": "c9fbbb1f-0975-50a5-8681-33a1679b091f"
}