Metabolic disorders



beriberi photo Avitaminosis - a chronic pathological condition that occurs when acute pronounced deficiency of any vitamin, as a consequence of violations of proper diet, or any manifestation of the chronic disease process.

should distinguish between such forms of this condition as "hypovitaminosis", in which there is increased consumption of different categories of vitamins, and "beriberi", which is the result of a complete lack of income and assimilation of vitamins in the body.

In a situation when the patient is showing signs of one type of vitamin deficiency, it is about monoavitaminoze, if observed in the patient's lack of vitamins belonging to the different categories of vitamin-like substances, it is necessary to begin treatment poliavitaminoza.

Causes of beriberi

Depending on the causes of beriberi are two main categories of vitamin deficiency: external and internal.Exogenous type of vitamin deficiency occurs in the absence of the fact of receipt of vital vitamins and other nut

rients with fortified foods, so this pathology is increasingly seen as a "spring beriberi."

endogenous form of vitamin deficiency occurs as a result of existing human chronic pathologies of the upper digestive tract, involving violation not only suction as the synthesis of a whole group of vitamins and vitamin-like substances.The autumn season is accompanied by a recurrence of diseases gastrointestinal profile, so the endogenous form of vitamin deficiency can be considered as "Autumn beriberi."The most common violation of the absorptive capacity of the small intestine is observed in an aggressive course of dysbiosis, the occurrence of which often contributes to uncontrolled long-term use of antibacterial drugs.

addition to nutritional reasons, the occurrence of vitamin deficiency can be triggered by entering a wide variety of "antivitamin substances", the activity of which is aimed at ending the absorption and digestion of vitamins.Thus, even when the intake of vitamin different categories of the body in a sufficient amount, the patient has symptoms of vitamin deficiency.

Fortunately, the recent incidence of avitaminosis dropped significantly, although in some episodes of the conditions for the emergence of a complete deficiency of a vitamin-like substance.

Symptoms and signs of beriberi

Due to the fact that vitamin deficiency is a chronic disease and has a long latency in relation to the growth asymptomatic period, called hypovitaminosis, early diagnosis of this condition is extremely difficult.During vitamin deficiencies to the fore in relation to diagnostic laboratory performs work methods of the analysis of blood and urine to determine the saturation level of the blood plasma of a particular form of the vitamin.An additional survey methodology that allows indirectly to judge the presence of vitamin deficiency is considered to be a urine test to determine the level of concentration of fission products vitamins.

With the development of beriberi nonspecific symptoms occur primarily as a recurrent weakness of disability, increased irritability and manifestations of so-called "chronic fatigue syndrome".During this latency period, some patients say pathological changes in the skin, hair and nails, namely, the emergence of areas of excessive peeling, the propensity to rashes, peeling nail plates, the intensity of these manifestations gradually increases.

The skin of patients suffering from vitamin deficiency are pale grayish hue and common acne is not only the face but also in other parts of the body.

Vitamin deficiency of vitamin A

pronounced manifestation of beriberi group A is represented by a separate nosology form of "follicular hyperkeratosis," which is a significant decrease in skin turgor and underlying soft tissue structures.

categories of fat-soluble vitamins Vitamin deficiency is a particular manifestation of the emergence of areas of hyperpigmentation on the skin, prone to rapid and mergers, as these vitamins have a strong antioxidant effect.

Vitamin deficiency of vitamin B2

Avitaminosis group B2 shown increased secretion of the sebaceous and sweat glands, recurrent herpes, as well as nervous disorders, depression and dysfunction of the digestive tract.

addition to the general non-specific symptoms of beriberi, which are observed in all forms of this disease, we must distinguish between the typical symptoms of vitamin deficiency of each individual vitamin.

Vitamin deficiency of vitamin C

Thus, vitamin deficiency of the group represented by disease entities called "scurvy."The basis of all manifestations of scurvy include a significant violation of the synthesis of collagen, which is involved in the formation of most of the structures of the human body.Since collagen is part of the connective tissue of vascular walls, a violation of its products leads to damage to the walls of blood vessels of various calibers and related bleeding of varying degrees of intensity, from small hemorrhages on the gums prior to a hemorrhage in the meninges.

visual manifestations of this disease is the appearance of a large number of subcutaneous hematomas of different localization and prevalence in the absence of the fact of injury.In pediatric scurvy manifested severe violation of cartilage structures, resulting in pediatric patients suffering from this pathology, lagging behind in growth.

Vitamin deficiency of vitamin B1

Avitaminosis group B1 has a classic called "beriberi" and the negative impact on the function of all internal organs of the human body, and to a greater extent on the structures of the nervous system.In addition to the development of polyneuropathy of various localization significantly impair quality of life, long-term vitamin deficiency B1 observed loss of brain structures, manifested cerebral and focal symptoms.

Vitamin deficiency of vitamin PP

main manifestation of beriberi is the defeat of the PP group of skin that become very dry and covered with large pockets ulcerations.

addition to the external features pellagra marked negative effect on the structure of the central nervous system, which is initially hidden within, and subsequently may cause depression, and hallucinogenic states even progressive dementia.

Vitamin deficiency of vitamin K

Avitaminosis of K is accompanied by the development of a massive hemorrhagic syndrome, which manifests itself in a large number of sources of bleeding and hemorrhage.Pathogenesis of occurrence of these changes is based on the violation of the processes of blood coagulation and not to pathological changes in blood vessels, as in scurvy.Vitamin deficiency K is an urgent condition and requires emergency medical correction with the use of replacement therapy.

danger to human life condition is megaloblastic anemia, which is nothing but a manifestation of beriberi group B12 that differs aggressive progressive course and can result in death, in the absence of timely rendered medical assistance.

main sphere of influence of the group of vitamin A is the organ of sight, so this type of vitamin deficiency manifests significant impairment of visual function until the development of blindness.

Avitaminosis Group D in the adult patient population almost does not occur, and is a frequent pediatric pathology manifested all the signs of severe rickets severity.

Avitaminosis children

Children's bodies are also prone to the development of deficiency diseases of various groups of vitamins, since the child is not enough to form a mechanism of absorption, digestion and excretion of metabolic products of vitamins and other nutrients coming with food.The initial symptoms of vitamin deficiency in a child is a low-level behavior, lack of appetite and impaired immunity.In long-term vitamin deficiency, provided that the total absence of medical correction, a sharp lag physical and even intellectual development of the child.

risk for the emergence of symptoms of beriberi are children born prematurely, because in the process of development of the fetus takes place insufficient vitamin replenishment of stocks from the mother, as the deposition of vitamins and essential nutrients in the body of the child occurs in the third trimester of pregnancy.

in breast period, the child vitamin deficiency may be due to increased intake of vitamins, because in this period the rapid growth and development of all the structures of the child's body.

classic type of beriberi is now found in pediatric practice is extremely rare, only in case of long-term malnutrition, which is a defect of elementary conditions for the care of the baby, or the presence of a child's innate forms fermentopathy and congenital diseases of the digestive system with malabsorption syndrome.

in turn deficient in essential vitamins in the body can contribute to the child's long-course parenteral type of food, the irrational use of chemotherapy drugs and chronic intoxication syndrome, resulting in malignant tumors.

In children, vitamin deficiency is characterized by sluggish over a long latency period, during which the level of vitamins in the body is reduced, however, all of the groups of vitamins are present in full force.In this period the use of such non-specific measures such as long daily walks in the fresh air, a good night's rest and adherence to diet can prevent further development of vitamin deficiency.

in early childhood cause of beriberi may be non-compliance with diet and rest the mother during pregnancy and lactation, and therefore, the child can develop gross malformations.For example, a congenital deficiency disease group A, accompanied by the emergence of the fetus violation Bookmark the optic nerve in the period of embryogenesis, so the birth of a child there is blindness and congenital cataract.

Avitaminoses group B accompanied by the development of severe neurological changes.Children suffering from this disorder characterized by increased irritability, lack of innate reflexes, muscle stiffness and imbalance of internal organs caused by the violation of their innervation.

most severe form of the health of the child vitamin deficiency is rickets, ie a deficiency of vitamin D. onset of the disease is considered to be the child's infancy, but in practice there are pediatric and congenital beriberi episodes of group D. Children suffering from this disorder have distinctive phenotypic features that allow experiencedpediatrician without laboratory analysis to establish the correct diagnosis.

Avitaminosis D is accompanied by gross deformities of bone structures the child's body, and increased fragility of bones that causes frequent pathological fractures at the least traumatic impact.In addition to the bone manifestations, D vitamin deficiency manifests gross neurological symptoms, which inhibits psychomotor development of the child.Due to the fact that this pathology can have serious negative consequences for the child's health, the World Association of neonatologists and pediatricians to develop a single scheme prevention of rickets, which is recommended to apply to all kids infants even with full lack of signs of vitamin A deficiency.

Avitaminosis on hand

Avitaminosis on hand is most often seen in patients continuously follow strict dietary guidelines and having bad habits of drinking alcohol and smoking.This category of patients Dietetic Association recommends year-round use vitamins in sufficient quantities, thus normalizing the metabolic processes in the body, stimulating the renovation and restoration of the structures at the cellular level.The preferred method of replenishing vitamin balance in the body is the correction of eating behavior, rather than the use of synthetic pharmaceutical multivitamin complexes.

In addition to the diet of patients with beriberi on hand, should include a sufficient number of different varieties of sea fish, which contains large amounts of nutrients that promote skin cell regeneration.

defeat of the skin in the form of reduced turgor, increased tendency to dryness and peeling may occur in any type of poliavitaminoza, but to a greater extent beriberi groups A and B is reflected on the skin of the palm and dorsum of the hand.In this situation, there is not only a decrease in skin turgor and elasticity, but also a violation of its integrity in the form of cracking, pitting and sites lihenifikatsii.

Due to the fact that vitamin deficiency negatively affects the functioning of the structures of the immune system, there is a total loss, not only the skin but also the rudiments of the skin (fading, dry hair, dandruff, brittle nail plates, increased sensitivity of tooth enamel).In addition, the skin on the hands insufficient content affects the human body the vitamin D and its metabolites.

The emergence of micro-skin palm and back of the hands is accompanied by severe itching and cracks quickly abscess and have a long period of healing.Some patients with vitamin deficiency complained of peeling the outer layer of skin, which is accompanied by discomfort and even pain.The appearance of wrinkles on the hands indicates the presence of the patient gipervitaminoza E.

treatment of beriberi

Due to the fact that vitamin deficiency is a chronic pathology with a long history and the gradual formation of the clinical treatment of this disease should be pathogenetically justified, individual and complex.

The immediate therapeutic interventions when vitamin deficiency is to determine the extent of vitamin deficiency by means of laboratory analyzes of blood plasma and urine, as well as the diagnosis of the underlying disease and pathological condition, which was the root causes of vitamin deficiency.Only under the condition of etiopathogenetic therapy can expect positive results from the treatment of beriberi.

therapeutic measures etiological orientation is considered timely elimination of signs of dysbiosis (Latsidofil 2 capsules three times a day for 20 days), early treatment of infectious colitis and organic nature, as well as preventive deworming (mebendazole 100 mg once only).

After determining the type of vitamin deficiency according to a laboratory study, you must immediately begin replacement therapy with synthetic pharmacological vitamin preparations with a preferred type of parenteral administration.Dietary advice in the event of complete clinical and laboratory symptom are secondary in nature and apply only as additional activities.

Appointment of vitamin A as a treatment of beriberi requires an individual approach to the selection of the required dose of the drug, which is largely dependent on the degree of vitamin deficiency and clinical manifestations.Thus, the average therapeutic dose of vitamin A is 50,000 IU, and in a situation where there are no cutaneous manifestations of beriberi, a sufficient dose of 25,000 IU believe.

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