Board Exam Question on Liver

[Lorenzo]

A 2-year old girl who has recently been adopted form Singapore is brought to the clinic by her parents. They are concerned because she is having trouble with her vision at night. The vitamin most likely deficient in this child is typically stored in which of the following organs?

a) appendix
b) gallbladder
c) liver
d) pancreas
e) stomach

[Lorenzo]

reasoning:


This patient has vitamin A deficiency (characterized by early symptoms of night blindness, dry conjunctivae, and gray plaques, as well as late symptoms of corneal ulceration and necrosis leading to perforation and blindness), which is commonly seen in children and pregnant women whose diets are deficient in Vitamin A, especially those from South East Asia. Vitamin A deficiency can also result from malabsorption following intestinal surgery, storage abnormalities secondary to liver disease, and excessive secretion due to proteinuria. Vitamin A is typically stored in the liver as retinyl esters.