Vitamin A deficiency
Low body retinol from malabsorption (cystic fibrosis, coeliac disease, biliary obstruction, short bowel syndrome) or chronically poor diet. Presents as night blindness, conjunctival and corneal xerosis (Bitot spots), keratomalacia with risk of blindness. In children in endemic regions WHO links the deficiency with higher mortality from measles and diarrhoea.
ICD-10 E502 drugs
Also known as: Hypovitaminosis A, Xerophthalmia
Drugs used for this condition
- ABeta-caroteneFirst line · Provitamin A (plant precursor of retinol)Beta-carotene is used as a safe retinol alternative for vitamin A deficiency in pregnant women (high-dose retinol is teratogenic), patients with severe malabsorption (coeliac, cystic fibrosis, Crohn, post-bariatric) and people on diets low in animal products. WHO 2011 recommends retinol as first choice in severe paediatric deficiency in developing countries; beta-carotene is an additional option in pregnancy and individual retinol intolerance.
- ARetinolFirst line · Fat-soluble vitamin AFirst-line treatment for confirmed vitamin A deficiency. WHO recommends oral 100 000 IU in infants aged 6–11 months and 200 000 IU in children over one year every 4–6 months in regions endemic for hypovitaminosis A, which lowers mortality from measles and diarrhoea. In adults with malabsorption (cystic fibrosis, coeliac disease, biliary obstruction, short bowel syndrome) AEMPS allows maintenance doses under serum retinol and liver function monitoring.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit