Hypovitaminosis A results from inadequate intake of vitamin A, fat malabsorption, or liver disorders and produces a variety of epithelial alterations.
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Epidemiology
The World Health Organizatiοn estimates that 45-122 countries have a vitamin A deficiency of public health significance based on the prevalence of night blindness and biochemical vitamin A deficiency (serum retinol concentration <0.70 µmol/L), respectively, in preschool-age children.
Night blindness is estimated to affect 5.2 million preschool-age children (33.3% globally) and 9.8 million pregnant women (15.3% globally). Regions of Africa and South-East Asia were found to be the most affected.
Clinical presentation
Manifestations include:
dry and scaly skin
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ocular effects
xerophthalmia (dry eye) - common cause of blindness in young children in developing countries
poor night vision/night blindness
photophobia
Bitot spots
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skull hyperostosis 5
can lead to secondary compressive optic neuropathy 5
decreased immunity
renal tract stones from pelvic keratinization
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in infancy
susceptibility to infection
cranial nerve injury
delayed growth
Radiographic features
slow bone development
widening of the cranial sutures with bulging fontanelles
skull hyperostosis 5
Treatment and prognosis
Administration of vitamin A given orally or parenterally, if malabsorption is the cause of the deficiency.
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