All issues > Volume 36(2); 1993

Original Article

J Korean Pediatr Soc. 1993;36(2):266-272. Published online February 15, 1993.

Urinary Vitamin C Loading Test and Therapeutic Effect of Vitamin C in Children with Idiopathic Recurrent Epistaxis

In Soon IS Park¹, Woo Yeong WY Chung¹, Soon Yong SY Lee¹

¹Department of Pediatrics, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea

Abstract

Recurrent epistaxis is not one of rare symptoms in children, the well-known causes of which are anatomical abnormalities of nasal cavity and systemic bleeding tendency. But, in the majority of cases of recurrent epistasix, it is usually very difficult to find out their underlying causes, so that the treatment is only symptomatic control of nasal bleeding whenever epistaxis occurs, but it usually is impossible to manage against their underlying causes as a specific therapy. The authors considered the breakdown or weakness of vascular integrity of nasal capillary vessel wall as an important factor of recurrent epistaxis, and vitamin C, which has an important role for the synthesis of collagen fiber, could influence to the vascular integrity of nasal capillary vessels. To elucidate the relation between recurrent epistaxis and the status of vitamin C in the tissue of the patients, the authors performed urinary vitamin C loading test measuring urinary excretion of vitamin C with high-performance liquid chromatography by Sirota et al in 19 cases of control group and 32 cases of patients with recurrent epistaxis, whose underlying diseases were not identified. And also the authors administered 1.0gm/day of vitamin C orally for the treatment of recurrent epistaxis and follow-up was done over 1 year from the beginning of treatment to evaluate the treatment response. The results were as follows: 1) The hemoglobin level was significantly decreased in patient group compared with that of control group (12.4¡¾0.8 vs 9.0¡¾3.2gm/dl). 2) The results of urine loading test of vitamin C, expressed as the percent excreted ratio, revealed significantly decresed in the patient group compared to that of the control group(9.1¡¾6.1% vs 13.6¡¾7.9%). 3) After treatment with 1.0gm/day of vitamin C orally, follow-up was possible in 23 cases of total 32 patients. Of the 23 patients, 밻xcellent?therapeutic response were in 16 cases (69.6%), 밽ood?response in 5 cases (21.7%), and 뱊o response?only in 2 cases (8.7%). The overall treatment response were in 21 cases (91.3%). In conclusion, it seems that majority of the patients with idiopathic recurrent epistaxis is in the deficient state of tissue vitamin C so that administration of vitamin C will be one of the effective therapy.

Keywords :Idiopathic recurrent epistaxis, Vitamin C, Urine vitamin C loading test