Plasma retinol in cholestatic infants and children: evaluation of therapy

Plasma retinol level was estimated in 20 patients with infantile cholestasis, 10 of them were supplemented with oral vitamin a 50, 000 iu/week. Ten children of matched age and sex were included as control. 70% of untreated cases had plasma retional level < 20 micro g dl[-1], in contrast to only 40% of treated ones. None of the control group had plasma retional level < 20 micro g dl[-1]. The least plasma retional level was observed at 7-9 months and it increased progressively with continuing oral therapy. Cases with neonatal hepatitis showed a significantly lower plasma retinol than those with extrahepatic biliary atresia [EHBA], paucity of intrahepatic bile ducts [PIHBD] and controls. It is realized that vitamin A deficiency is an established problem in infantile cholestasis. Supplementation with vit A is mandatory. Oral dose of 50,000 IU/week, attempated in this study is nearly satisfactory to prevent hypovitaminosis A in this group of children, however, parenteeral administration may be required in severe cholestasis and with non compliance with oral therapy