{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:03:22Z","timestamp":1790935402391,"version":"4.1.0"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,5,1]]},"abstract":"<jats:p>Objective.\u2003To test the hypothesis that high-dose vitamin A supplements will enhance recovery of children hospitalized for the treatment of community-acquired pneumonia.<\/jats:p><jats:p>Design.\u2003We conducted a randomized, double-blind, placebo-controlled clinical trial of high-dose vitamin A supplements among children 3 months to 10 years of age (N = 95) admitted to hospital with community-acquired pneumonia in Lima, Peru. Children \u22641 year of age received 100\u2009000 IU of water-miscible vitamin A on admission to the hospital and an additional 50\u2009000 IU the next day. Children &amp;gt;1 year of age received 200\u2009000 IU on admission and 100\u2009000 IU the next day.<\/jats:p><jats:p>Results.\u2003Children receiving vitamin A (n = 48) had lower blood oxygen saturation (the mean difference on day 3 in hospital was 1.1%), higher prevalence rates of retractions (37% in the vitamin A group vs 15% in the placebo group on day 3), auscultatory evidence of consolidation (28% in the vitamin A group vs 17% in the placebo group on day 3), and were more likely to require supplemental oxygen (21% in the vitamin A group vs 8% in the placebo group on day 3) than children in the placebo group (n = 47). Adjustment for baseline severity of disease and nutritional status did not alter the association of vitamin A with increased clinical severity, although the difference in blood oxygen saturation was no longer statistically significant. No differences were seen in duration of hospitalization or in chest x-ray changes 14 days after admission. No deaths occurred, and toxicity of vitamin A was not seen.<\/jats:p><jats:p>Conclusions.\u2003This study indicates that high-dose vitamin A supplements cause modest adverse effects in children recovering from pneumonia and should not be used therapeutically in such patients unless there is clinical evidence of vitamin A deficiency or concurrent measles infection.<\/jats:p>","DOI":"10.1542\/peds.101.5.e3","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"e3-e3","source":"Crossref","is-referenced-by-count":76,"title":["Adverse Effects of High-dose Vitamin A Supplements in Children Hospitalized With Pneumonia"],"prefix":"10.1542","volume":"101","author":[{"given":"Charles B.","family":"Stephensen","sequence":"first","affiliation":[{"name":"From the Department of International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Miguel","family":"Franchi","sequence":"additional","affiliation":[{"name":"Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herminio","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Campos","sequence":"additional","affiliation":[{"name":"Mathematics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Gilman","sequence":"additional","affiliation":[{"name":"Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru;"},{"name":"Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, Maryland; and"},{"name":"A.B. PRISMA, Lima, Peru."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose O.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"From the Department of International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,5,1]]},"reference":[{"key":"2021121007112751100_B1"},{"key":"2021121007112751100_B2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1136\/bmj.306.6874.366","article-title":"Vitamin A supplementation in infectious diseases: a meta-analysis.","volume":"306","author":"Glasziou","year":"1993","journal-title":"Br Med J."},{"key":"2021121007112751100_B3","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1001\/jama.1993.03500070078033","article-title":"Vitamin A supplementation and child mortality. A meta-analysis.","volume":"269","author":"Fawzi","year":"1993","journal-title":"JAMA."},{"key":"2021121007112751100_B4","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1093\/ajcn\/61.6.1295","article-title":"Vitamin A supplementation and morbidity among preschool children in south India.","volume":"61","author":"Ramakrishnan","year":"1995","journal-title":"Am J Clin Nutr."},{"key":"2021121007112751100_B5","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1096\/fasebj.10.9.8801180","article-title":"Vitamin A and retinoids in antiviral responses.","volume":"10","author":"Ross","year":"1996","journal-title":"FASEB J."},{"key":"2021121007112751100_B6","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1056\/NEJM199007193230304","article-title":"A randomized, controlled trial of vitamin A in children with severe measles.","volume":"323","author":"Hussey","year":"1990","journal-title":"N Engl J Med."},{"key":"2021121007112751100_B7","first-page":"1014","article-title":"American Academy of Pediatrics, Committee on Infectious Diseases. Vitamin A treatment of measles.","volume":"91","author":"Anonymous","year":"1993","journal-title":"Pediatrics."},{"key":"2021121007112751100_B8","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S0022-3476(95)70416-7","article-title":"Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections.","volume":"126","author":"Kjolhede","year":"1995","journal-title":"J Pediatr."},{"key":"2021121007112751100_B9","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/ajcn\/58.1.110","article-title":"Association of diarrhea and low serum retinol in Peruvian children.","volume":"58","author":"Salazar-Lindo","year":"1993","journal-title":"Am J Clin Nutr."},{"key":"2021121007112751100_B10"},{"key":"2021121007112751100_B11","first-page":"233","article-title":"Decrease in serum levels of retinol and its binding protein (RBP) in infection [in Spanish].","volume":"29","author":"Arroyave","year":"1979","journal-title":"Arch Latinoam Nutr."},{"key":"2021121007112751100_B12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1136\/bmj.315.7107.505","article-title":"Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia.","volume":"315","author":"Nacul","year":"1997","journal-title":"Br Med J."},{"key":"2021121007112751100_B13","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/j.1651-2227.1997.tb14805.x","article-title":"High dose vitamin A supplementation in the course of pneumonia in Vietnamese children.","volume":"86","author":"Si","year":"1997","journal-title":"Acta Paediatr."},{"key":"2021121007112751100_B14","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1093\/ajcn\/55.4.857","article-title":"Evaluation of vitamin A absorption by using oil-soluble and water-miscible vitamin A preparations in normal adults and in patients with gastrointestinal disease.","volume":"55","author":"Johnson","year":"1992","journal-title":"Am J Clin Nutr."},{"key":"2021121007112751100_B15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/archpedi.1996.02170260029004","article-title":"Vitamin A and respiratory syncytial virus infection. Serum levels and supplementation trial.","volume":"150","author":"Quinlan","year":"1996","journal-title":"Arch Pediatr Adolesc Med."},{"key":"2021121007112751100_B16","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/00006454-199609000-00008","article-title":"Vitamin A therapy for children with respiratory syncytial virus infection: a multicenter trial in the United States.","volume":"15","author":"Bresee","year":"1996","journal-title":"Pediatr Infect Dis J."},{"key":"2021121007112751100_B17","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1097\/00006454-199609000-00009","article-title":"Treatment of respiratory syncytial virus infection with vitamin A: a randomized, placebo-controlled trial in Santiago, Chile.","volume":"15","author":"Dowell","year":"1996","journal-title":"Pediatr Infect Dis J."},{"key":"2021121007112751100_B18","doi-asserted-by":"crossref","first-page":"450","DOI":"10.4049\/jimmunol.154.1.450","article-title":"Retinoid treatment of experimental allergic encephalomyelitis. 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