Vitamin A deficiency in Crohn's disease

Abstract

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 μmol/l (34.3 2mg%)). Five of these were outpatients and plasma retinol was only slightly reduced (> 1.0 μol/l (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 μmol/l (28.6 μg%) and weighed <80% ideal. Three of these had impaired dark adaptation and a plasma retinol concentration of < 0.8 μmol/l (< 22.9 μg%). 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 μmol/l (< 22.9 μg%) run a high risk of night blindness. Vitamin supplements should be given and protein depletion corrected.