• Shunichi Adachi, Michiko Torio, Sayaka Okuzono, Yoshitomo Motomura, Yuko Ichimiya, Yuri Sonoda, Jyunya Nagata, Misato Okamoto, Shoji Notomi, Masafumi Sanefuji, Yasunari Sakai, and Shouichi Ohga.
• Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
• Nutrition. 2021 Oct 1; 90: 111275.

BackgroundMalnutrition and vitamin deficiency are growing concerns in the clinical management of children with autism spectrum disorder (ASD). This case report presents a boy with ASD who developed vitamin A deficiency during follow-up.Case ReportA 7-y-old boy had been diagnosed with ASD and developmental delay at age 18 mo. He developed convulsions associated with hypocalcemia and vitamin D deficiency at 3 y of age. Although vitamin D supplementation was continued, he was only able to eat rice, green tea, and fried potatoes from 3 y of age to age 7 y. He had started rubbing his eyes and had refused to open his eyes 9 mo before. An ophthalmologic examination showed bilateral corneal ulcers and right corneal perforation. Vitamin A was immediately supplemented with a nasogastric tube; however, his right eye was surgically enucleated against the persistent infection.Literature ReviewA search of the relevant literature from 1993 to 2020 identified 11 cases of patients with ASD (5-17 y of age) who developed vitamin A deficiency owing to malnutrition. Only 4 cases (36%) had a full recovery in visual acuity.ConclusionVitamin A deficiency frequently causes irreversible visual impairment in children with ASD. Vigilant monitoring of vitamin levels prevents unfavorable outcomes in children with ASD and difficulty in food intake.Copyright © 2021 Elsevier Inc. All rights reserved.

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