Retinol Concentrations in Liver and Serum Among Children Who Died in a Diarrheal, Hospital in Bangladesh

To determine the vitamin A status of children with severe illnesses, we compared retinol concentrations in the liver and serum, histopathology of liver, and clinical complications in subjects who died in a diarrheal hospital. The median age of the study children(12 boys and 11 girls) was 24 months. About 87% (20/23) of the children were severely malnourished, having a median weight-for-age z scores of -4.35 (range, -5.55 to -2.50). All children were admitted with a history of diarrhea. They had multiple diseases or complications leading to death, including pneumonia, septicemia, colitis, and protein energy malnutrition. Stool cultures yielded Shigella in ii, Vibrio cholera in three, and Samonella group-B in one. Liver and serum retinol concentrations were found inadequate in 79% (15/19) and 89% (17/19) of the subjects, respectively. Concentrations of retinol in the liver and serum correlated strongly even after controlling for liver weight (r = 0.72, p \u3c 0.001) and weight-for-age z scores (r = 0.73,p \u3c 0.001). Liver histopathology showed moderate to diffuse fatty changes in those children who had deficient liver retinol (\u3c0.07 mu mol/g). These results indicate that children with fatal illnesses and complications have markedly decreased liver and serum retinol. (C) 1999 Elsevier Science Inc