Depressed serum concentration and urinary excretion of retinol during acute shigellosis

In 58 hospitalized children aged 6-72 mo old with dysentery, Shigellae were isolated from stool cultures in 45 cases, of which 33 were S. dysenteriae type 1. Serum retinol concentrations (μmol/1) of patients with Shigella were markedly depressed at admission and became normal spontaneously at recovery without supplemental vitamin A (mean±SE, 0.35±0.04 vs. 1.14±0.07, p<0.001). Serum retinol at admission was significantly lower among the patients with poor nutrition status, high fever, and S. dysenteriae type 1 infection, compared to those with better nutrition (0.23±0.04 vs 0.44±0.05, p=0.002), low or no fever (0.19±0.02 vs 0.48±0.05, p<0.001), and with other Shigella infection (0.27±0.04 vs 0.56±0.05, p<0.001), respectively. Urinary 24-h retinol concentrations (μmol/1) were significantly higher among patients who were more malnourished (80±43 vs 14±10, p<0.0001), who had high fever (92±44 vs 2±1, p<0.0001) and who had S. dysenteriae 1 (59±28 vs 5±5, p=0.004). These results indicate that serum retinol is transiently depressed in shigellosis, that this depression is greater in children with malnutrition, fever and severe shigellosis, that levels are directly associated with RBP and TTR and inversely with acute phase proteins (CRP and AGP), and that the urinary loss of retinol is directly associated with poor nutritional status, fever and severity of shigellosis.