Treatment & Prevention of Vitamin A deficiency

Prevention

The diet should include dark green leafy vegetables, deep- or bright-colored fruits (eg, papayas, oranges), carrots, and yellow vegetables (eg, squash, pumpkin). Vitamin A–fortified milk and cereals, liver, egg yolks, and fish liver oils are helpful. Carotenoids are absorbed better when consumed with some dietary fat. If milk allergy is suspected in infants, they should be given adequate vitamin A in formula feedings.

Treatment

  • Vitamin A palmitate

Dietary deficiency is traditionally treated with vitamin A palmitate in oil 60,000 IU po once/day for 2 days, followed by 4500 IU po once/day. If vomiting or malabsorption is present or xerophthalmia is probable, a dose of 50,000 IU for infants < 6 mo, 100,000 IU for infants 6 to 12 mo, or 200,000 IU for children > 12 mo and adults should be given for 2 days, with a third dose at least 2 wk later. The same doses are recommended for infants and children with complicated measles. Infants born of HIV-positive mothers should receive 50,000 IU (15,000 RAE) within 48 h of birth. Prolonged daily administration of large doses, especially to infants, must be avoided because toxicity may result.

For pregnant or breastfeeding women, prophylactic or therapeutic doses should not exceed 10,000 IU (3000 RAE)/day to avoid possible damage to the fetus or infant.

Key Points

  • Vitamin A deficiency usually results from dietary deficiency, as occurs in areas where rice, devoid of ?-carotene, is the staple food, but it may result from disorders that interfere with the absorption, storage, or transport of vitamin A.
  • Ocular findings include impaired night vision (early), conjunctival deposits, and keratomalacia.
  • In children with severe deficiency, growth is slowed and risk of infection is increased.
  • Diagnose based on ocular findings and serum retinol levels.
  • Treat with vitamin A palmitate.


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