A preterm infant who received prolonged parenteral nutrition for neonatal cholestasis develops a Coombs-negative hemolytic anemia at 3 months of age. Retinal examination shows peripheral pigmentation. Which vitamin deficiency best explains these findings?
- A Vitamin K
- B Vitamin A
- C Vitamin E ✓
- D Vitamin D
Correct answer: C. Vitamin E
Explanation
Vitamin E is a lipid-soluble antioxidant that protects red cell membranes from peroxidation; deficiency in premature infants and in fat malabsorption states such as cholestasis causes hemolytic anemia, and chronic deficiency produces a spinocerebellar syndrome with retinopathy. Vitamin K deficiency causes bleeding, not hemolysis, which eliminates option A despite the shared malabsorption risk.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.