Vitamin A Deficiency Workup

  • Author: George Ansstas, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Mar 29, 2012
 

Laboratory Studies

  • A serum retinol study is a costly but direct measure using high-performance liquid chromatography. A value of less than 0.7 mg/L in children younger than 12 years is considered low.[17]
  • A serum RBP study is easier to perform and less expensive than a serum retinol study, because RBP is a protein and can be detected by an immunologic assay. RBP is also a more stable compound than retinol with respect to light and temperature. However, RBP levels are less accurate, because they are affected by serum protein concentrations and because types of RBP cannot be differentiated.[18, 19, 20]
  • The serum retinol level may be low during infection because of a transient decrease in the RBP.
  • A zinc level is useful because zinc deficiency interferes with RBP production.
  • An iron panel is useful because iron deficiency can affect the metabolism of vitamin A.
  • Albumin levels are indirect measures of vitamin A levels.
  • Obtain a complete blood count (CBC) with differential if anemia, infection, or sepsis is a possibility.
  • An electrolyte evaluation and liver function studies should be performed to evaluate for nutritional and volume status.
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Imaging Studies

  • In children, radiographic films of the long bones may be useful when an evaluation is being made for bone growth and for excessive deposition of periosteal bone.
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Procedures

  • Dark-adaptation threshold should be tested.[21]
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Contributor Information and Disclosures
Author

George Ansstas, MD  Instructor, Department of Internal Medicine, Washington University School of Medicine

George Ansstas, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Jigna Thakore, MD  Fellow, Department of Gastroenterology, Dayton Veterans Administration Medical Center

Jigna Thakore, MD is a member of the following medical societies: American College of Gastroenterology and American Society of Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

N Gopalswamy, MD  Chairman, Professor of Internal Medicine, Department of Gastroenterology, Wright State University, Boonshoft School of Medicine, Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Udaya M Kabadi, MD  Professor, Department of Medicine, University of Iowa College of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Romesh Khardori, MD, PhD, FACP  Professor of Endocrinology, Director of Training Program, Division of Endocrinology, Diabetes and Metabolism, Strelitz Diabetes and Endocrine Disorders Institute, Department of Internal Medicine, Eastern Virginia Medical School

Romesh Khardori, MD, PhD, FACP is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, and Endocrine Society

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References

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