Nutritional Deficiencies

29/04/2013 by admin | Gastroenterology
  1. Xerophthalmia = lack of Vit A
    1. o Major cause of blindness in the Tropics
    2. o Conjunctivae become dry and develop oval/triangular spots (=Bitot’s spots). Cornea becomes cloudy and soft.
    3. o Tx: Vit A 200,000 units stat po, repeat in 24h, then again 7/7 later. Seek special advice if pregnant (Vit A embryopathy must be avoided)
  2. Beri-beri and Wernicke’s encephalopathy = lack of Vit B1 (Thiamine)
    1. o ‘Wet’ = heart failure and oedema, or ‘dry’ = neuropathy
  3. Angular stomatis and cheilitis (=swollen lips) = lack of Vit B2 (Riboflavin)
  4. Polyneuropathy = lack of Vit B6 (Pyridoxine)
  5. Macrocytic anaemia, neuropathy, glossitis = lack of Vit B12
  6. Scurvy = lack of Vit C
    1. o Can be through lack of fruit in diet/pregnancy
    2. o p/c: listlessness, anorexia, cachexia, gingivitis, loose teeth, foul breath (=halitosis), bleeding from gums, nose hair follicles, or into joints, bladder or gut, muscle pain, weakness, oedema.
    3. o Tx: dietary education and give ascorbic acid >250mg/d/po
  7. Rickets and osteomalacia = lack of Vit D
    1. o Rickets = Softening of bones in children due to lack of Vit D, magnesium, calcium or phosphorus
    2. o p/c: bone pain, bowing of long bones, bowed legs (=’genu varum’), knocked knees (=’genu valgum’), hypocalcaemia, muscle weakness or tetany, craniotabes (soft skull)
    3. o Tx for rickets (known as ‘antirachitic treatment’): diet (increase calcium, phosphates and Vit D) and sunlight (UVB – when sun is highest in the sky). Supplementation can be given in the form of Vit D3 (cholecalciferol)
    4. o Osteomalacia = similar process happening in adult bones
  8. Haemolysis and neurological deficit = lack of Vit E
  9. Bleeding disorders = lack of Vit K
  1. Macrocytic anaemia = lack of Folate
  2. Pellagra = lack of Nicotinic acid (Nicotinamide)
    1. o Triad: Diarrhoea, Dementia, and Dermatitis (in Casal’s necklace distribution)
    2. o Also may p/c: neuropathy, depression, insomnia, tremor, rigidity, atxia, fits.
    3. o May occur in carcinoid syndrome (=diverse group of tumours of enterochromaffin cell [neural crest] origin – which can produce serotonin) and with use of anti-TB meds (isoniazide)
    4. o Tx: education, electrolyte replacement, nicotinamide 100mg/4h/po
  3. Menkes’ kinky hair syndrome = lack of Copper
  4. Cardiomyopathy = lack of Selenium
  5. Acrodermatitis enteropathica and poor wound healing = lack of Zinc 
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