Symptomatic vitamin A deficiency in a paediatric patient with short bowel syndrome

Area of Science:

• Ophthalmology
• Pediatrics
• Gastroenterology

Background:

• Vitamin A deficiency, leading to xerophthalmia, is uncommon in developed nations.
• Malabsorption conditions, such as short bowel syndrome (SBS), can precipitate vitamin A deficiency.
• Short bowel syndrome (SBS) often requires long-term parenteral nutrition support.

Purpose of the Study:

• To report a case of symptomatic xerophthalmia in a pediatric patient with SBS.
• To highlight the potential for vitamin A deficiency despite parenteral nutrition.
• To emphasize the importance of regular ophthalmologic screening and prompt diagnosis.

Main Methods:

• Case presentation of an early-adolescent male with hypoganglionosis-related SBS.
• Clinical assessment including night blindness, conjunctival xerosis, and Bitot's spots.
• Biochemical evaluation of serum retinol levels and intramuscular vitamin A administration.

Main Results:

• The patient presented with severe vitamin A deficiency (serum retinol 4.2 µg/dL).
• Ocular manifestations, including night blindness and xerosis, were observed.
• Intramuscular high-dose vitamin A led to complete resolution of symptoms.

Conclusions:

• Pediatric patients with SBS are at risk for symptomatic xerophthalmia, irrespective of nutritional support.
• Regular ophthalmologic examinations are crucial for early detection of ocular abnormalities.
• Intramuscular vitamin A is an effective therapeutic intervention for vitamin A deficiency secondary to malabsorption.