A former preterm infant now 8 weeks old develops hemolytic anemia with peripheral edema. Muscle biopsy shows lipid accumulation in myofibers. Which vitamin deficiency is the most likely cause?

• A Vitamin K
• B Vitamin D
• C Vitamin A
• D Vitamin E ✓

Explanation

Vitamin E (alpha-tocopherol) is the major lipid-soluble chain-breaking antioxidant protecting membrane polyunsaturated fatty acids from peroxidation. Premature infants have low body stores and are prone to vitamin E deficiency, presenting with hemolytic anemia, edema, and sometimes thrombocytosis. In older children and adults, chronic deficiency causes spinocerebellar degeneration resembling Friedreich ataxia. Vitamin K deficiency causes hemorrhage, not hemolysis, which eliminates option A.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.