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General Reference ⬇

Nejm 1984;310:1023

Pathophys and Cause ⬆ ⬇

Cause:Vit A deficiency, a fat-soluble vitamin

Pathophys:Necessary for visual pigment of eye; other tissue functions not known. Columnar epithelium changes to stratified squamous (keratinization) in trachea, urinary tract, conjunctiva. ß-Carotene and other carotenes are precursors

Epidemiology ⬆ ⬇

Increased in low-income areas and developing countries

Signs and Symptoms ⬆ ⬇

Sx:Poor growth in children; impaired vision day and night

Si:Keratinization of eye and Bitot spots on sclera (gray plaques); dryness of eyes and skin can be severe (Nejm 1994;330:994)

Complications ⬆ ⬇

Increased mortality and morbidity from most infections including measles (Nejm 1990;323:160)

Lab and Xray ⬆ ⬇

Lab: Chem:Low vit A levels (1 U = 0.3 µgm)

Treatment ⬆

Rx:Vit A; given in small weekly doses reduces overall mortality by 50% in undernourished Indian children (Nejm 1990;323:929) probably by decreasing mortality from respiratory illness; given 10 000 U/lb po q3mo, it decreases diarrheal illness in HIV-infected infants (Am J Publ Hlth 1995;85:1076)