Sir.—The article by Frieden et al1 in the February 1992 issue of AJDC provided useful information about the changes in plasma retinol during measles infection in young children. In this report, as well as in other studies, plasma and/or serum retinol levels were markedly reduced during the acute phase of measles, but only Frieden et al have reported that plasma retinol returned to normal levels during convalescence compared with a local reference population: Based on these findings, Frieden et al1 proposed a relationship between plasma retinol and measles, whereby the measles virus causes low vitamin A levels that in turn result in more severe measles. We suspect that the association between fever and low plasma retinol is a consequence of an acute-phase reaction during infection.
AJDC—Vol 146, October 1992
In Table 3 of the article, several indices of measles severity were significantly associated (P values between.02 and.06)
FRANCISCO J. ROSALES, CHRIS KJOLHEDE. Low Vitamin A During Measles. Am J Dis Child. 1992;146(10):1133–1134. doi:10.1001/archpedi.1992.02160220019011