[Acute reversible night blindness caused by vitamin A deficiency in pancreatic carcinoma].
BACKGROUND
Vitamin A deficiency is a leading cause of blindness in childhood in the developing countries. In developed countries xerophthalmia occurs mainly as secondary hypovitaminosis due to malabsorption in chronic alcoholism or intestinal disorders.


METHODS
A 24-year-old female patient complained of night blindness since one week. There was a history of pancreas tail resection combined with radiation due to a papillary low grade cystic carcinoma at the age of 15. During a review period of 9 years of follow-up there was a slow disseminated metastatic spread including the liver. Despite a progressive tumor cachexia the patient was practising a profession. Visual acuity was 20/20 OU with normal visual fields. Dark adaptation was reduced to one log unit and scotopic electroretinography was extinguished. Serum vitamin A level was reduced to 75 ng/ml (normal range 400-700 ng/ml).


RESULTS
Under vitamin A substitution dark adaption and scotopic electroretinography normalized and night blindness disappeared within 7 days.


CONCLUSIONS
In malabsorption syndromes, especially in combination with liver manifestations, xerophthalmia should be considered as a potential complication. Vitamin A substitution should be administered if necessary. In cases of malignant tumors differential diagnosis includes the cancer associated retinopathy (CAR).
Augenklinik mit Poliklinik, Friedrich-Alexander Universität Erlangen-Nürnberg.
U
U
Schönherr
D000328:Adult; D002291:Carcinoma, Papillary / Q000150:complications* / Q000628:therapy; D003131:Combined Modality Therapy; D003623:Dark Adaptation / Q000187:drug effects; D004596:Electroretinography / Q000187:drug effects; D005260:Female; D006801:Humans; D009755:Night Blindness / Q000188:drug therapy / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000628:therapy; D014801:Vitamin A / Q000008:administration & dosage; D014802:Vitamin A Deficiency / Q000188:drug therapy / Q000209:etiology*
D014801:Vitamin A
Akute reversible Nachtblindheit durch Vitamin-A-Mangel bei Pankreaskarzinom.