vitamin disorders-arun sir
TRANSCRIPT
-
8/8/2019 Vitamin Disorders-Arun Sir
1/43
Page 1
DEFICIENCY
DISORDERS OF
VITAMINS
RENJINI
-
8/8/2019 Vitamin Disorders-Arun Sir
2/43
Page 2
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
3/43
Page 3
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
-
8/8/2019 Vitamin Disorders-Arun Sir
4/43
Page 4
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
5/43
Page 5
-
8/8/2019 Vitamin Disorders-Arun Sir
6/43
Page 6
Night Blindness
Xerophthalmia
Bitots Spot
Keratomalacia
Phrynoderma (Follicular
Hyperkeratosis)
VITAMIN A
-
8/8/2019 Vitamin Disorders-Arun Sir
7/43
Page 7
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
-
8/8/2019 Vitamin Disorders-Arun Sir
8/43
Page 8
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-
-
8/8/2019 Vitamin Disorders-Arun Sir
9/43
Page 9NYCTALOPIA XEROPHTHALMIA
-
8/8/2019 Vitamin Disorders-Arun Sir
10/43
Page 10
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
-
8/8/2019 Vitamin Disorders-Arun Sir
11/43
Page 11
-
8/8/2019 Vitamin Disorders-Arun Sir
12/43
Page 12
VITAMIN D
Rickets
Osteomalacia
Osteoporosis
VITAMIN D
-
8/8/2019 Vitamin Disorders-Arun Sir
13/43
Page 13
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
14/43
Page 14
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
-
8/8/2019 Vitamin Disorders-Arun Sir
15/43
Page 15
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
16/43
Page 16RICKETS OSTEOMALACIA
-
8/8/2019 Vitamin Disorders-Arun Sir
17/43
Page 17
-
8/8/2019 Vitamin Disorders-Arun Sir
18/43
Page 18
Reproductive failure
Liver necrosis
Muscular dystrophy
Erythrocyte Haemolysis
Megaloblastic anaemia Neurological disorders
VITAMIN E
-
8/8/2019 Vitamin Disorders-Arun Sir
19/43
Page 19
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
20/43
Page 20
-
8/8/2019 Vitamin Disorders-Arun Sir
21/43
Page 21
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
-
8/8/2019 Vitamin Disorders-Arun Sir
22/43
Page 22
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
23/43
Page 23
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
24/43
Page 24
HEMORRHAGIC DISEASEOF
RABBIT KIDNEY
-
8/8/2019 Vitamin Disorders-Arun Sir
25/43
Page 25
-
8/8/2019 Vitamin Disorders-Arun Sir
26/43
Page 26
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)
-
8/8/2019 Vitamin Disorders-Arun Sir
27/43
Page 27
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
-
8/8/2019 Vitamin Disorders-Arun Sir
28/43
Page 28
-
8/8/2019 Vitamin Disorders-Arun Sir
29/43
Page 29
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)
-
8/8/2019 Vitamin Disorders-Arun Sir
30/43
Page 30
-
8/8/2019 Vitamin Disorders-Arun Sir
31/43
Page 31
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)
-
8/8/2019 Vitamin Disorders-Arun Sir
32/43
Page 32
CHELOSIS GLOSITIS
-
8/8/2019 Vitamin Disorders-Arun Sir
33/43
Page 33
-
8/8/2019 Vitamin Disorders-Arun Sir
34/43
Page 34
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)
-
8/8/2019 Vitamin Disorders-Arun Sir
35/43
Page 35
-
8/8/2019 Vitamin Disorders-Arun Sir
36/43
Page 36
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)
-
8/8/2019 Vitamin Disorders-Arun Sir
37/43
Page 37
-
8/8/2019 Vitamin Disorders-Arun Sir
38/43
Page 38
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
-
8/8/2019 Vitamin Disorders-Arun Sir
39/43
Page 39
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.
-
8/8/2019 Vitamin Disorders-Arun Sir
40/43
Page 40
-
8/8/2019 Vitamin Disorders-Arun Sir
41/43
Page 41
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
-
8/8/2019 Vitamin Disorders-Arun Sir
42/43
Page 42
-
8/8/2019 Vitamin Disorders-Arun Sir
43/43
Page 43
THANK YOU
RENJINI