Further Clinical Investigations Into the Diseases Arising in Consequence of a Deficiency in the Fat-Soluble a Factor

Abstract

My description of the diseases occurring in children from a deficiency in the fat-soluble A factor was quickly acknowledged by those physiologists who were working at vitamin problems. This was due to the close parallel, which in many respects exists between the disease I have observed in children and the condition that can be produced in young rats, by keeping them for a long time on a diet poor in the f at \ x=req-\ soluble A factor but otherwise adequate. With clinicians it was a different matter. Although nearly a decade has passed since I published my first contributions on this subject, there are still many clinicians, especially in Germany, who have never appreciated the fact that the absence of the fat-soluble A factor gives rise to a well defined disease just as, for example, the absence of the C factor does. There are, however, many German authors who trace a connection between the deficient growth of the children and the great prevalence and serious course of tuberculosis and similar diseases during the war on the one hand, and the lack of the proper food substances (i. e., those containing the fat-soluble A factor) on the other, but that it is an indication of the absence of the fat-soluble A factor is usually not understood or not alluded to. With regard to the characteristic symptom, xerophthalmia, it is stated by many that this condition is not caused by a deficiency in the fat-soluble A factor alone but is merely the result of general marasmus.

New insights and changing paradigms in the regulation of vitamin A metabolism in development

“…A sufficient intake of vitamin A is critical for normal embryonic development; [42][43][44][45] however, administration of excess vitamin A or ATRA during early pregnancy can lead to congenital malformations of the head, heart, and limbs. [46][47][48][49][50] Hypervitaminosis A has also been associated with abnormal conditions in adults such as an increased risk of bone fractures in the elderly, [51][52][53] and in addition to teratogenic effects, pharmacological doses of ATRA can also cause toxicity associated with symptoms of retinoic acid syndrome.…”

The role of vitamin A in preventing renal scarring secondary to pyelonephritis

“…The WHO recommended that children should take vitamin A capsules every 6 months, along with strategies to supply vitamin A in food in those regions of the world where vitamin A deficiency is a health problem [ 2]. After Block [ 3] proposed that vitamin A deficiency exacerbated UTIs, there have been few studies examining the relationship of vitamin A to UTI. Brown et al [ 4] reported that the favourable effect of vitamin A on epithelialization had a role in preventing infections.…”

The effect of vitamin A on renal damage following acute pyelonephritis in children

“…Renal scarring is significantly correlated with presence of gross vesicoureteral reflux and recurrent pyelonephritis [12]. According to several studies, vitamin A deficiency causes an increase in urinary infections incidence while the administration of vitamin A leads to reduction in UTI incidence [2,4,6,15]. In a study performed on children with recurrent UTI, the severity of renal scarring was revealed to have an inverse correlation with the serum vitamin A concentration [13,15].…”