Vitamin A deficiency in Crohn's disease.

Abstract

SUMMARY Fifty two patients with Crohn's disease (31 outpatients and 21 inpatients) were investigated for evidence of vitamin A deficiency. Eleven (21%) had low plasma retinol concentrations (<1.2 umol/l (34.3 ,ug%)). Five of these were outpatients and plasma retinol was only slightly reduced (>1.0 ,umoWl (28.6%)). All outpatients weighed 80% or-more of ideal, and were considered at low risk of developing vitamin A deficiency. In contrast, of the six inpatients with low plasma retinol concentration, five had a level of <1*0 ,umoUl (28.6 ,ug%) and weighed <80% ideal. Three of these had impaired dark adaptation and a plasma retinol concentration of <0.8 ,umol/1 (<22.9 ,ug%). As a group, the inpatients were more protein depleted than the outpatients, with respect to serum albumin (p<0-01), transferrin (p<0-001), and prealbumin (p<0.001) but retinol binding protein levels were not significantly lower. It is suggested that patients with extensive small bowel Crohn's disease, who weigh <80% of ideal weight, merit measurement of plasma retinol concentration. Those with plasma retinol <0.8 ,umol/l (<22.9

Serum retinol level in patients with colorectal premalignant and malignant lesions

“…These findings confirmed earlier results of others for patients with Crohn's disease (Main, 1983;Schoelmerich, 1985). Furthermore, low serum retinol levels were found in patients with chronic pancreatitis or cholecystitis and in those with acute febrile illnesses (unpublished data).…”

Vitamin A Status in 137 Patients with Crohn’s Disease

“…An ele vated fecal fat excretion was found in about half the Crohn's patients by Russell et al [8] and Main et al [6] as well as in the present study. Low serum carotene levels are often considered a useful and easily measured in dicator of fat malabsorption.…”

“…In contrast, the present study found normal serum retinol levels in all 137 outpa tients with CD over a 6-month period, al though low serum carotene values were ob served in 20-25% of these patients. A differ ence in retinol-binding protein levels, as a result of different protein status, may par tially account for the discrepancy in the prevalence of low serum retinol values be tween the present study and the study by Main et al [6]. Protein depletion was preva lent in the study by Main et al [6] but not in the present study.…”

“…However, 12 of the 13 patients had serum retinol levels lower than those observed in subjects with normal liver reserved, and all had abnormal dark adapta tion. Main et al [6] observed low plasma retinol concentrations in 11 of 52 (21 %) pa tients with CD (5 outpatients and 6 inpa tients). In contrast, the present study found normal serum retinol levels in all 137 outpa tients with CD over a 6-month period, al though low serum carotene values were ob served in 20-25% of these patients.…”

“…Vitamin A deficiency has been reported in a small number of patients with Crohn's disease (CD) [6,8], and high doses of oral vitamin A were found to return dark adapta tion to normal [8], Skogh et al [9] reported the correction of defective intestinal perme ability and the cessation of diarrhea in one patient with CD after supplementation with oral vitamin A. Dvorak [2] postulated on the possible therapeutic role of high-dose oral vitamin A in the enhancement of the protec tive barrier functions of the gut in patients with CD. However, in a long-term double blind study by Wright et al [14] vitamin A supplementation was not found to be of clin ical benefit to patients with CD.…”