Vitamin E deficiency in chronic cholestasis
Chronic cholestasis represents a symptom of various conditions, where the flow or the formation of bile (a digestive fluid that helps the digestion of fats) is impaired. This results in bile salts, pigments, and fats (lipids) to accumulate in the blood stream instead of being eliminated through the digestive tract. The main organs affected are the liver and the intestine, secondary effects can involve every organ system. Albeit chronic cholestasis in itself is not a primary cause of death, it is the cause of considerable morbidity mainly due to liver disease and systemic illness.
Bile aids at the digestion of food lipids and at the elimination of certain waste products (hemoglobin, cholesterol). When bile enters the small intestine it emulsifies fats so digestive enzymes can digest them more efficiently.
Patients with chronic cholestasis cannot absorb fat soluble vitamins. Vitamin E being one of the latter, its deficiency is therefore a complication often observed in patients presenting with this condition. Vitamin E deficiency can lead to progressive demyelinisation affecting the nervous system and consequently to neurological abnormalities.