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Vitamin A Level in Raised Intracranial Pressure in Children: A Cross-Sectional, Open-Label Study

Aims: To study vitamin A level in pediatric patients with raised Intra Cranial Pressure (ICP). Settings and Design: A cross-sectional, open-label study in the pediatric ward at Sir T G hospital and Government Medical College, Bhavnagar. Methods: 30 patients in the age group of 2 months to 12 years admitted in the pediatric ward were included in the study during the period of 01/01/2015 to 30/08/2015. The subjects were selected based on having symptoms and signs suggestive of raised ICP. 15 subjects were selected as a control group from a pediatric outpatient without any major illness. Results: 17 male and 13 female were enrolled in this study. 14/30 (46.6%) patients had low level (< 0.3 mg/L) of vitamin A, of which 9 were male and 5 were female; 7 patients (50%) belonged to the age group of 2 12 months; only 4/14 had any sign (dry skin) of vitamin A deficiency. Out of 13 with raised ICP in infancy, 12 had bulging AF (7 low, 1 raised vitamin A level). Vomiting in 21 patients and convulsion in 19 was observed. 10/21 patients with vomiting had low vitamin A levels. The most common sign was neck stiffness. The most common diagnosis seen with raised ICP was pyogenic meningitis (16/30, eight had low vitamin A level). A total of 18 patients had abnormal Vitamin A levels, 14 had low and 4 had high (> 0.6 mg/L) levels. In 15 control subjects, only one subject had low vitamin A level without any clinical manifestation of vitamin A deficiency, and rest had a normal level. Conclusion: Abnormal levels of Vitamin A were seen in raised ICP in children including in infancy in 18/30 children; half 14/30 had low levels and 4/30 had high levels. 14/15 control had normal levels. Careful monitoring and administration of vitamin A is recommended in raised ICP in children.