ascorbic-acid and Cholecystolithiasis

Evidence based prevention of cholecystolithiasis. Cholesterol cholelithiasis is one of the most common and expensive gastroenterological diseases. Beside common exogenous risk factors, recent molecular genetic studies have identified genetic risk factors for both cholesterol and pigment stone formation. Examples are low phospholipid-associated cholelithiasis due to mutations of the gene encoding the hepatocanalicular phosphatidylcholine transporter, and pigment stones in association with mutations of the ileal bile salt transporter gene. Evidence-based options for primary prevention of cholecystolithiasis include physical activity, slow weight reduction, regular vitamin C supplementation, and moderate coffee consumption. The ongoing genome projects provide the basis for future epidemiological studies of human gallstone (LITH) genes, which might offer new prospects for individual risk assessment and prevention of gallstones.

Topics: Ascorbic Acid; Biliary Tract Diseases; Carrier Proteins; Cholecystolithiasis; Coffee; Colic; Evidence-Based Medicine; Exercise; Gallbladder Neoplasms; Humans; Phospholipid Transfer Proteins; Primary Prevention; Risk Factors; Weight Loss

Hemolysis induced by high dose ascorbic acid (AA) in patients with G6PD deficiency has been reported, but is rare. To our knowledge, this is the first reported case of a male with G6PD deficiency, coexpressed with cholecystolithiasis and cholecystitis, who developed extreme hemolysis and hyperbilirubinemia after receiving pharmacological doses ascorbic acid infusion.. A 27-year-old man history with glucose-6-phosphate dehydrogenase deficiency was admitted to our hospital because of cholecystolithiasis and cholecystitis. He appeared with scleral jaundice and very deep colored urine after receiving pharmacological doses ascorbic acid infusion.. Clinical findings when combined with his medical history and various laboratory results confirmed the diagnosis as hemolysis and hyperbilirubinemia induced by ascorbic acid.. The patient was treated with steroids, hepatoprotective drugs, and folic acid in addition avoidance of agents with known hemolysis risk (such as vitamin C).. As a result, the patient's symptoms from hemolytic jaundice improved, hemoglobin remained stable, and the patient was discharged 11 days later.. Clinicians should bear in mind the possibility that vitamin C exposure may result in hemolysis in patients with G6PD deficiency, especially in those with known severe disease.

Topics: Adult; Ascorbic Acid; Cholecystitis; Cholecystolithiasis; Glucosephosphate Dehydrogenase Deficiency; Humans; Hyperbilirubinemia; Jaundice; Male