EFFICACY OF WATER-SOLUBLE VITAMIN-E IN THE TREATMENT OF VITAMIN-E MALABSORPTION IN SHORT-BOWEL SYNDROME

A water-soluble form of vitamin E, tocopheryl succinate polyethylene g lycol 1000 (TPGS), was used as an oral vitamin E supplement in a 71-y- old patient with severe fat malabsorption and vitamin E deficiency sec ondary to short-bowel syndrome. An absorption test with deuterium-labe led TPGS demonstrated that TPGS was absorbed and the released alpha-to copherol was transported normally in lipoproteins. The disappearance p ortion of the deuterated alpha-tocopherol curves were parallel to thos e in control subjects, suggesting normal metabolic turnover of alpha-t ocopherol. Long-term (3 y) supplementation with orally administered TP GS (10360 mg or 4000 IU/d) maintained normal plasma alpha-tocopherol c oncentrations, raised adipose tissue alpha-tocopherol concentrations, and prevented further progression of the neurological abnormalities re sulting from vitamin E deficiency. Thus, TPGS can be an effective vita min E supplement in short-bowel syndrome despite severe fat malabsorpt ion.