Vitamin A deficiency in New York City

July 18, 2010, Lancet

In high-income countries, diseases related to vitamin deficiencies are not as frequent as in poorer settings but are nonetheless regular occurrences. In a Clinical Picture published Online First and in next week's Lancet, the case of a 24-year-old pregnant woman suffering vitamin A deficiency is reported. The Clinical Picture is written by Dr Stephen H Tsang, Edward Harkness Eye Institute, Columbia University Medical Center, New York, USA, and colleagues.

The woman presented to New York-Presbyterian Hospital with a 7-week history of progressive loss of vision, mostly at night. Tests of her eyes using electroretinography revealed a severe dysfunction in the rod and responsible for vision, and other irregularities in each eye. A blood analysis revealed deficiency—the woman had a concentration of less than 0.002 µmol/L, well below the normal range of 0.70—2.8 µmol/L. Following vitamin A supplementation, her vision returned to normal.

The authors say: " can be secondary to poor intestinal absorption due to , Crohn's disease or pancreatic dysfunction. Our patient had anorexia nervosa and had limited her diet to white onions, white potatoes, and red meat for the past 7 years."

The authors add that a 'steal effect'—in which the fetus takes the vital vitamin A it needs from its mother— could also have contributed to the woman's symptoms.

Dr Tsang adds: "It is essential to diagnose and treat this potentially curable form of blindness."

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