Vitamin A deficiency

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Background

  • One of the most common vitamin deficiencies in developing countries
  • Most common cause of blindness in developing world
  • In US, most commonly found in conjunction with fat malabsorption syndromes (e.g. IBD, pancreatic insufficiency, sprue, cystic fibrosis, laxative abuse)

Clinical Features

  • Visual loss
    • Night blindness (early)
    • Dry conjunctivae with small white patches (Bitot spots)
    • Corneal ulceration/necrosis (keratomalacia), perforation, endophthalmitis, and blindness (late)
  • Dry, hyperkeratinized skin, hair, and nails
  • Pruritus
  • Loss of taste

Differential Diagnosis

Acute Vision Loss (Noninflamed)

Emergent Diagnosis

Vitamin deficiencies

Evaluation

  • Eye exam
  • Serum Vitamin A level below 30–65 mg/dL

Management

  • Early: vitamin A 30,000 IU PO daily x 1 week
  • Advanced: vitamin A 20,000 IU/kg PO daily for at least 5 days

Disposition

See Also

External Links

References

Authors: