Urinary Retinol Excretion in Children with Acute Watery Diarrhoea

Amal K. Mitra, Mohammad A. Wahed, Ashish K. Chowdhury, Charles B. Stephensen


Children with diarrhoea due to rotavirus infection excrete retinol in urine.This study aimed at demonstrating the extent and mechanism of urinary retinol excretion in children with acute watery diarrhoea caused by pathogens other han rotavirus.Thirty-two children, aged five months o five years, hospitalized with watery diarrhoea predominantly due to enterotoxigenic Escherichia coli in Bangladesh, were studied.Their serum retinol and retinol-binding protein (RBP) were low at admission and increased significantly after recovery from illness.The mean hospital stay of hese patients was four days. Forty-seven percent of the children excreted retinol in urine on day 1, and about 38% continued excreting retinol on day 3. The estimated urinary retinol loss of  3.44 μmol for he illness episode represented more than 40% of liver retinol reserve (8.25 μmol)  in malnourished children. A conservative estimate of he loss would represent at least 20% of he liver reserve in relatively better-nourished children. Kidney tubular dysfunctions of increased RBP excretion significantly predicted urinary retinol excretion in children with watery diarrhoea.

Key words :Diarrhoea,Acute; Diarrhoea, Infantile; Rotavirus; Rotavirus infections;Vitamin A; Vitamin A deficiency; Retinol excretion; Retinol-binding protein; Escherichia coli ; Bangladesh

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