STUDIES OF TOCOPHEROL DEFICIENCY IN INFANTS AND CHILDREN

VITAMIN E was recognized some 35 years ago as a fat-soluble substance necessary for reproduction in the rat. Its potency is measured by assay for fertility and its synonym, tocopherol, comes from Greek words which mean "to bear offspring." Review of the original studies of Mason and his co-workers and of his interpretive writings provides a good stimulus for pediatric interest in the subject. It is proposed to review some literature on the pathologic lesions produced in animals and on the tocopherol content of foods, and then summarize data collected at the Colorado General, Sinai and Johns Hopkins Hospitals on tocopherol deficiency in infants and children. Most of the latter data and detailed references to the literature have been published elsewhere. PATHOLOGIC FINDINGS IN EXPERIMENTAL ANIMALS Although vitamin E has been dubbed the anti-sterility vitamin, its absence from the diet has produced a variety of pathologic states, differing from one species to another, and at different ages in the same species. Some of the conditions found are: Fetal resorption; testicular degeneration; encephalomalacia; "exudative diathesis"; generalized edema; brownish discoloration of smooth muscle, adipose tissue and liver; acute hemorrhagic necrosis of the liver; degeneration of renal tubules; focal necrosis of cardiac muscle; and nutritional muscular dystrophy. Provocative findings in E-deficient animals that call to mind clinical problems in premature infants are: Hemorrhagic manifestations in rat fetuses and chick embryos; hemorrhages in the lungs, visceral and cranial cavities in puppies; subcutaneous, pulmonary and cerebral edema in young chickens, anemia in monkeys; and hemolysis after administration of large doses of vitamin K to rats.