VITAMIN-C STATUS IN PATIENTS WITH ACUTE-PANCREATITIS

Vitamin C is a key antioxidant in human blood plasma and hence could i nfluence the outcome of conditions such as acute pancreatitis in which oxidative stress apparently plays a pivotal role. The concentrations of vitamin C and its immediately bioavailable form, ascorbic acid, in fasting plasma samples from 30 healthy volunteers were compared with t hose in admission samples from 29 consecutive patients with acute panc reatitis and 27 patients with other acute abdominal crises. Median (ra nge) levels of vitamin C and ascorbic acid, respectively, were 15 (6.3 -19) and 12 (4.5-18) mug/ml in the control group, 2.8 (0.3-10) and < 0 .5 (<0.5-6.0) mug/ml in patients with acute pancreatitis, and 3.7 (0.6 -15) and 2.3 (<0.5-15) mug/ml in those with other acute abdominal prob lems. Admission plasma samples showed equally low vitamin C levels in both groups of patients (P < 0.001 versus controls), but those from pa tients with acute pancreatitis were further characterized by a disprop ortionate reduction in ascorbic acid, such that the concentration of a scorbic acid and its ratio to vitamin C were both significantly lower than in samples from patients with an acute abdomen (P < 0.005 and P < 0.001 respectively). It is concluded that the stress of an acute intr a-abdominal crisis is accompanied by a non-specific decrease in the pl asma level of vitamin C. In acute pancreatitis early and profound oxid ative stress compounds this problem by denaturing the available vitami n. There may be a case for the judicious parenteral administration of ascorbic acid to patients with acute pancreatitis to boost plasma anti oxidant defence.