Night blindness and Crohn's disease.

Area of Science:

• Ophthalmology
• Gastroenterology
• Nutritional Science

Background:

• Malnutrition is a common complication in Crohn's disease (CD).
• Bowel resections, often necessary for CD management, can exacerbate nutritional deficiencies.
• Vitamin A deficiency is a recognized risk in CD patients, potentially causing visual impairment.

Observation:

• A 60-year-old male with a history of CD and multiple bowel resections presented with progressive bilateral nyctalopia (night blindness).
• Laboratory tests revealed markedly depleted serum vitamin A levels (11 µg/dL).
• Ophthalmic examination, including electroretinography, showed impaired rod and cone function.

Findings:

• The patient received vitamin A supplementation, initially via intramuscular injection.
• Following supplementation, serum vitamin A levels normalized (78 µg/dL).
• Subjective improvement in night vision was reported by the patient.

Implications:

• Nyctalopia in Crohn's disease patients warrants investigation for vitamin A deficiency.
• Prompt ophthalmological evaluation and vitamin A level assessment are crucial.
• Timely vitamin A supplementation can reverse visual symptoms and correct deficiency in CD patients.