An 18-month-old boy with biliary atresia and chronic cholestasis develops a Coombs-negative hemolytic anemia. Peripheral smear shows acanthocytes (burr cells). Which vitamin deficiency is responsible?
- A Vitamin A
- B Vitamin E ✓
- C Vitamin D
- D Vitamin K
Correct answer: B. Vitamin E
Explanation
Vitamin E is fat soluble and its absorption requires bile salts, so children with chronic cholestasis develop deficiency. It acts as a membrane antioxidant protecting red cell membranes from peroxidation; deficiency produces a hemolytic anemia with characteristic acanthocytes on the smear. Vitamin K deficiency causes bleeding through defective clotting factor carboxylation, not hemolysis.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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