Fast Five Quiz: Common Nutritional Deficiencies

Romesh Khardori, MD, PhD

Disclosures

February 26, 2019

For patients with vitamin A deficiency syndromes, treatment includes daily oral supplements, as follows:

  • Children aged 3 years or younger: 600 µg (2000 IU)

  • Children aged 4-8 years: 900 µg (3000 IU)

  • Children aged 9-13 years: 1700 µg (5665 IU)

  • Children aged 14-18 years: 2800 µg (9335 IU)

  • All adults: 3000 µg (10,000 IU)

Therapeutic doses for severe disease include 60,000 µg (200,000 IU), which has been shown to reduce child mortality rates by 35% to 70%.

The recommended daily intake of vitamin A for various age groups are as follows:

  • Infants aged 1 year or younger: 375 µg

  • Children aged 1-3 years: 400 µg

  • Children aged 4-6 years: 500 µg

  • Children aged 7-10 years: 700 µg

  • All males older than 10 years: 1000 mcg

  • All females older than 10 years: 800 mcg

Signs and symptoms of vitamin A deficiency include the following:

  • Bitot spots

  • Blindness due to retinal injury

  • Poor adaptation to darkness (nyctalopia)

  • Dry skin

  • Dry hair

  • Pruritus

  • Brittle nails

  • Keratomalacia

  • Xerophthalmia

  • Corneal perforation

  • Follicular hyperkeratosis (phrynoderma) secondary to blockage of hair follicles with plugs of keratin

  • Other signs: excessive deposition of periosteal bone secondary to reduced osteoclastic activity, anemia, keratinization of mucous membranes, and impairment of the humoral and cell-mediated immune system

A serum retinol-binding protein (RBP) study is easier to perform and less expensive than a serum retinol study, because RBP is a protein and can be detected by an immunologic assay. RBP is also a more stable compound than retinol with respect to light and temperature. However, RBP levels are less accurate, because they are affected by serum protein concentrations and because types of RBP cannot be differentiated.

Read more about vitamin A deficiency.

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