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VITAMIN A AND MEASLES IN THE U.S.

Studies in underdeveloped countries have shown that children with measles have low levels of serum retinol (vitamin A), that low levels are associated with greater measles severity, and that vitamin A therapy reduces case fatality (see Journal Watch accession number 930312003). This study finds similar associations in the U.S.

Low retinol levels (median, 0.70 micromoles/l) were found in 72 percent of 114 children under 6 years old who had serologically confirmed measles during an outbreak in Wisconsin. Hospitalized children had even lower levels (median, 0.56 micromoles/l). Illness severity was inversely associated with serum retinol concentration, but retinol level did not predict measles complications such as tracheitis and otitis media. Two children under 2 years old died from pulmonary complications; their retinol levels were 0.48 and 0.52 micromoles/l. Four children had serum retinol measured during convalescence; their mean levels rose to 1.81 micromoles/l without receiving vitamin A.

Comment: It is still unknown why measles lowers serum retinol. Until clinical trials of vitamin A in measles are conducted, it seems reasonable to provide vitamin A for severe cases.

— RAD

Published in Journal Watch General Medicine June 18, 1993

Citation(s):

Butler JC et al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993 Jun 91 1176-1181.

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