vitamin disorders-arun sir

8/8/2019 Vitamin Disorders-Arun Sir

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DEFICIENCY

DISORDERS OF

VITAMINS

RENJINI


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VITAMINS A group of organic compounds essential in

small quantities for human growth, metabolism,development; found in small amounts in plant and

animal foods; deficiencies of specific vitamins

produce specific metabolic as well as

physiological disorders.

Vitamins ="vital amines"

The concept of vitamins HOPKINS

(accessory food factors)

The term vitamin FUNK. According to him

natural foods contained distinct anti-beriberi, anti-

scurvy, anti-rickets and anti-pellagra factors called

vitamins-VITAMINE THEORY.


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FAT SOLUBLE VITAMINS

VITAMIN AVITAMIN DVITAMIN EVITAMIN K

WATER SOLUBLE VITAMINS

VITAMIN B COMPLEX

Thiamine

RiboflavinNicotinic acidPyridoxinPantothenic acidFolic acidBiotin

Vitamin B12PABAInositolCholine

VITAMIN C (Ascorbic acid)

VITAMIN PLIPOIC ACID, CARNITINE &TAURINE


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AVITAMINOSIS(Deficiency of Vitamins)

Lack of one or more vitamins.

It may be of 2 general types:

PRIMARY or Direct: This arises

due to inadequate intake ofvitamins resulting from

alcoholism, dietary fads etc.

SECONDARY or Conditioned: This

arises due to other factors such asmalabsorption, allergies, anorexia,

GI disorders, increased excretion

etc.


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Night Blindness

Xerophthalmia

Bitots Spot

Keratomalacia

Phrynoderma (Follicular

Hyperkeratosis)

VITAMIN A


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NIGHT BLINDNESS Inability to see objects in dim light.

Also called Nyctalopia.

Dark adaptation time is increased.

SYMPTOMS

Dry eyes

Blurred vision

TREATMENT

Taking Vitamin A supplements Eating diet with Vitamin A


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XEROPHTHALMIA Dryness of the conjunctiva and

cornea.

Keratinisation of epithelial cells.

Eye fails to produce tears.

The conjunctiva becomes dry, thickand wrinkled.

If untreated, it can lead to corneal

ulceration and degeneration.

This results in destruction of cornea

referred as Keratomalacia (total

blindness)

White triangular plaques in-


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Page 9NYCTALOPIA XEROPHTHALMIA


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OTHER DEFICIENCY

MANIFESTATIONSEffect on Growth:

Growth retardation due toimpairment of skeletal formation.

Effect on Reproduction:

Degeneration of germinal epitheliumleading to sterility in males.

Effect on Skin and Epithelial cells:

Skin becomes dry and rough

Keratinization of epithelial cells of GItract, urinary tract, respiratory tractetc.

Formation of urinary stones

Increased bacterial infections


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VITAMIN D

Rickets

Osteomalacia

Osteoporosis

VITAMIN D


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RICKETS

The word Rickets is derived from anold English word wrikken meaning

to twist. It is charecterized by

bone deformities due to incomplete

mineralization, resulting insoft and pliable bones.

It occurs in Children.


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Symptoms

Bone pain or tenderness arms, legs, spine,

Skeletal deformities

Increased tendency toward bone fracturesDental deformities

delayed formation of teeth, painful teeth

defects in the structure of teeth, holes in theenamel

increased incidence of cavities in the teeth(dental caries)

Muscle cramps,decreases muscle development.

Impaired growth

short stature.

Slow growth in children.

Treatment

Plenty of sunlight, fresh air and muscular

exercise


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OSTEOMALACIA (Adult rickets)

It is the softening of bones in adults.

The word Osteomalacia is derived fromGreek word osteon- bone &malakia-softness.

It involves demineralization of bones

Symptoms

diffuse bone pain, especially in the hips

muscle weakness

numbness around the mouth

spasms of hands or feet

Treatment

Oral supplements of vitamin D, calcium,and phosphorus .

Larger doses of vitamin D combined with

exposure to ultraviolet light.


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Page 16RICKETS OSTEOMALACIA


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Reproductive failure

Liver necrosis

Muscular dystrophy

Erythrocyte Haemolysis

Megaloblastic anaemia Neurological disorders

VITAMIN E


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Reproductive failure Degenerative changes in Uterus

Testicular degeneration Embryonic degeneration.

This results in Sterility.

Erythrocyte Haemolysis RBC undergoes haemolysis

when treated with Hydrogen

peroxide.

Anaemia

Lack of Hematopoeisis.


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VITAMIN K

It involves lowering of

Prothrombin level and increased

clotting time of blood.

This can lead to Haemorrhagic

conditions.

Its deficiency can occur in 2

ways:

Inadequate intake of Vit K

Inadequate intestinal

absorption

VITAMIN K


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Inadequate intake of Vit K

Hemorrhagic disease of new born.

Impaired production ofcoagulationfactors II, VII, IX, X.

It occurs mostly in new borne

babies, due to low vit.K stores. Alsovit.K cannot cross placenta.

There is an increased risk of

bleeding in umbilicus, mucousmembrane, GI tract etc.


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Inadequate intestinal

absorption It may result from:

Lack of bile in the intestine due to

defective secretion of bile salts as in

liver disorders

Pyloric orintestinal obstruction

Poor absorption due to diarrhea or

dysentery ormalabsorptionsyndromes.


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HEMORRHAGIC DISEASEOF

RABBIT KIDNEY


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THIAMINE

BERI-BERI It is a disease of nervous system

characterized byPolyneuritis(degeneration of the peripheral

nerves) leading to paralysis,muscular atrophy, CVD and GIdisorders.

SYMPTOMS

Fatigue, apathy, irritability,depression, drowsiness,anorexia, insomnia

(sleeplessness), nausea

VITAMIN B1 (THIAMINE)


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DRY BERI-BERI

Difficulty walking

Loss of muscle function

Mental confusion/speech difficulties

Pain, Vomiting

Strange eye movements (nystagmus)

WET BERI-BERI Peripheral edema

Increased heart rate

Shortness of breath

Swelling of the lower legs INFANT BERI-BERI

Leisons

Hemorrhage

Edema


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Pellagra and Beri-Beri patients

Use of Oral contraceptives Strict Vegetarians

CHELOSIS

Fissuring at the corners of the mouth and lips

GLOSSITIS Tongue is smooth and loss papillary structure.

TREATMENT

Diet containing meat, milk, eggs, leafyvegetables etc

If no response occurs, intramuscular injection of2 mg of riboflavin in saline solution may beadministered 3 times in a day.

VITAMIN B2 (RIBOFLAVIN)


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PELLAGRA

Pellis=skin; agra=rough

Dermatitis , Diarrhea, Dementia

SYMPTOMS

Anorexia, irritability, anxiety, apathy,fatigue, burning sensations, numbness

and dizziness. Nervous symptoms include depression,

disorientation, insomnia, demyelinationand degeneration of ganglion cells

TREATMENT

Skin leisons are covered by soothers.

Intravenous injection of 100mg niacin inconditions of poor intestinal absorption.

Diet containing 50-300mg of niacin per

day is given.

VITAMIN B3 (NIACIN)


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CHELOSIS GLOSITIS


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PYRIDOXINE

SYMPTOMS

Convulsions, anaemia, dematitis, GIdisorders.

RBCs are usually microcytic andhyperchromic.

Increased serum iron Saturation of iron-binding protien

Hemosiderin deposits in bonemarrow and liver

Failure of iron utiilization for Hbsynthesis

100 mg of vitamin is givenintramuscularly as treatment.

VITAMIN B6 (PYRIDOXIN)


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Glossitis, GI disorders, Megaloblasticanaemia

Pregnant women and infants aremore susceptible

Weakness, palpitation, giddiness,faintness

Urine contains excess bile pigments

Skin, tongue, cornea etc looks blood

less. Loss ofapetite, diarrhoea, flatulence,

vomiting etc.

VITAMIN B9 (FOLIC ACID)


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Strict VegetariansJuvenille (congenital) Pernicious

anemia :

A rare disease

inability to secrete gastric intrinsicfactors.

This occurs mostly in children with9months to 10 years of age.

SYMPTOMS

Irritability, anorexia, listlessness,tongue is smooth, red and painful.

Neur. Symptoms:ataxias,paresthesias, hyporeflexia, conus,

coma etc

VITAMIN B12


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Adult Pernicious anemia

Anemia caused by failure oferythrocyte formation.

RBC becomes abnormallylarge andfewer in number (1.3 mmper cubicmm instead of the normal 4-5million)

SYMPTOMS Weakness, loss of weight and the

nervous system is also graduallyaffected because ofdemyelinization

of large nerve fibers of the spinalcord. This can lead to death.

Monthlyintramuscularadministration of1mg of vitamin B12

is sufficient.


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SCURVY

Tender bones Edematous swellings

Petechial hemorrhages

Bleeding gums

Scorbutic rosary Delayed wound healing

Cessation of bone growth

Anemia

Pyrexia

Sicca syndromeTREATMENT

Diet rich in ascorbic acid, citrus fruits ,orange juice, tomato juice etc.

The daily therapeutic dose is 100-200 mg

or more orally or parenterally.

VITAMIN C


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THANK YOU

RENJINI

vitamin disorders-arun sir

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