VITAMIN A in RHEUMATIC FEVER

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Abstract
(1) Vitamin A was estimated in the blood plasma of 100 patients with rheumatic fever, and the results were averaged according to arbitrary ranges of body temperature, or according to the time after the commencement of the disease. (2) Vitamin A was considerably reduced during the febrile stage of the disease, but equally severe reductions were found in smaller groups of patients with pneumonia, pleural effusion, rheumatoid arthritis, erythema nodosum or acute tonsillitis. (3) During convalescence the mean body temperature first reached normal, followed by vitamin A and by E.S.R. (4) The changes in the mean carotenoid contents of the plasma were less clear-cut than those in vitamin A, but there was a considerable reduction when the body temperature exceeded 100°. (5) The inverse relation between body temperature and vitamin A was not always observed in individual cases. Very low vitamin A values were found in specimens collected from nonfebrile patients with various diseases within 14 days of death. (6) A re-examination of earlier data indicated that the vitamin A reserves found in the livers of children who had died from heart diseases, mainly rheumatic in origin, were much lower than in children who had died by accident. (7) No claim can be made either that rheumatic fever differs from other febrile diseases in its effect on vitamin A metabolism, or that vitamin A is the only nutrient affected. The danger that the prolonged course of rheumatic fever may eventually exhaust the vitamin A reserves in the liver, and so produce a conditioned deficiency of vitamin A, should not, however, be ignored.