We have observed that lymphocyte proliferation and IL-2 secretion tend to be lower in children with SCD who have suboptimal vitamin A status vs those with adequate plasma retinol levels.19 In a previous small study, we reported that nearly 53% of the children with SCD had plasma levels of retinol-binding protein (RBP) <30 mg/L, but no child had albumin (Alb) levels <35 g/L.20 The study suggested the presence of mild to moderate PEM in our SCD patient population. This evidence concerns the gene ALB and Schnyder corneal dystrophy.