URINARY-EXCRETION OF RETINOL IN CHILDREN WITH ACUTE DIARRHEA

Acute infections of childhood are associated with an increased rate of xerophthalmia, apparently due to depletion of vitamin A stores. The m echanism responsible for this is not known. Recently, it has been repo rted that severe infections in adult patients (ie, sepsis and pneumoni a) result in excretion of large quantities of retinol in the urine. In 44 children hospitalized for treatment of acute diarrhea we found mea n urinary excretions of 1.44 mu mol retinol/24 h on day 1 of hospitali zation, 0.62 mu mol retinol/24 h on day 2, and 0.23 mu mol/24 h on day 3. Healthy control subjects matched for age did not excrete measurabl e amounts of retinol in the urine. Retinol excretion was associated st rongly with rotavirus diarrhea and presence of fever. Furthermore, ser um retinol concentration was negatively associated with duration of di arrhea before hospitalization, suggesting that urinary excretion of re tinol may be an important contributor to vitamin A depletion.