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Vitamin Deficiency Disorders

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Title: Vitamin Deficiency Disorders


1
Vitamin Deficiency Disorders
  • Abdelaziz Elamin
  • MD, PhD, FRCPCH
  • Professor of Child Health
  • College of Medicine
  • Sultan Qaboos University
  • Muscat, Oman
  • azizmin_at_hotmail.com

2
BACKGROUND
  • Vitamins are organic substances that are
    essential for several enzymatic functions in
    human metabolism
  • Thiamine was discovered in 1912 was thought to
    be a vital amine compound thus the term vitamin
    was invented

3
VITAMINS
  • Vitamins are classified according to solubility
    into fat soluble water soluble.
  • 13 vitamins are known, 4 fat soluble (KEDA) 9
    water soluble (C, Folate the B
    group).

4
VITAMIN A
  • Vitamin A is a generic term for many related
    compounds.
  • Retinol (alcohol), Retinal (aldehyde) are often
    called preformed vitamin A. Retinal can be
    converted by the body to retinoic acid which is
    known to affect gene transcription.
  • Body can convert b-carotene to retinol, thus
    called provitamin A.

5
FUNCTIONS
  • Vision integrity of eye formation of rodopsin
    necessary for dark adaptation.
  • Regulation of gene expression vital to cell
    differentiation physiologic processes
  • Immunity important for activation of T
    lymphocyte, maturation of WBC integrity of
    physiological barrier.
  • Growth development

6
Nutrient Interactions
  • Zinc deficiency interfere with vitamin A
    metabolism in several ways
  • It decreases the synthesis of retinol binding
    protein, which transports retinol to tissues.
  • It decreases the activity of the enzyme retinyl
    palmitate, which is necessary for release of
    retinol from the liver.
  • Zn is needed for the enzyme that convert retinol
    into retinal.

7
Nutrient Interactions/2
  • Iron vitamin A.
  • Vitamin A deficiency may exacerbate IDF
  • Vitamin A supplementation improves iron status
    among children pregnant women.
  • Combining vitamin A with iron controls IDA more
    quickly effectively than using iron alone.

8
VITAMIN A UNITS
  • 1 mg of retinol 6 mg of b-carotene.
  • 3 mg of retinol 10 international units of
    vitamin A.
  • 100 mg carrots contain 10 mg of b-carotene.

9
Recommended Allowance
10
RICH DIETARY SOURCES
11
Vitamin A deficiency
  • Deficiency of vitamin A leads to
  • Night blindness xerophthalmia
  • Growth retardation
  • Acquired immune deficiency
  • Keritinization of epithelia in RT, GIT UT with
    increased risk of RTI, malabsorption UTI.

12
THERAPEUTIC USES
  • Vitamin A deficiency
  • Boosting immunity of infants
  • Skin disorders
  • Acute promyelotic leukemia
  • Cancer prevention (lung breast)

13
TOXICITY
  • Vitamin A in excess leads to
  • Dermatitis with xanthosis cutis
  • Hepatosplenomegaly
  • Bone pain increased risk of fracture
  • Pseudotumor Cerebri

14
(No Transcript)
15
VITAMIN D
  • Vitamin D comprises a group of sterols the most
    important of which are cholecalciferol (vitamin
    D3) ergosterol (vitamin D2).
  • Humans animal utilize only vitamin D3 they
    can produce it inside their bodies from
    cholesterol.
  • Cholesterol is converted to 7-dehydro-cholesterol
    (7DC), which is a precursor of vitamin D3.

16
VITAMIN D
  • Exposure to the ultraviolet rays in the sunlight
    convert 7DC to cholecalciferol.
  • Vitamin D3 is metabolically inactive until it is
    hydroxylated in the kidney the liver to the
    active form 1,25 Dihydroxycholecalciferol.
  • 1,25 DHC acts as a hormone rather than a vitamin
    endocrine paracrine properties.

17
FUNCTIONS
  • Calcium metabolism vitamin D enhances ca
    absorption in the gut renal tubules.
  • Cell differentiation particularly of collagen
    skin epithelium
  • Immunity important for Cell Mediated Immunity
    coordination of the immune response.

18
Vitamin D deficiency
  • Deficiency of vitamin D leads to
  • Rickets in small children.
  • Osteomalacia
  • Osteoporosis

19
GROUPS AT RISK
  • Infants
  • Elderly
  • Dark skinned
  • Covered women
  • Kidney failure patients
  • Patients with chronic liver disease
  • Fat malabsorption disorders
  • Genetic types of rickets
  • Patients on anticonvulsant drugs

20
Sources of Vitamin D
  • Sunlight is the most important source
  • Fish liver oil
  • Fish sea food (herring salmon)
  • Eggs
  • Plants do not contain vitamin D3

21
THERAPEUTIC USES
  • Rickets Osteomalacia
  • Osteoporosis
  • Psoriasis
  • Cancer prevention (prostate colorectal)
  • Autoimmune diseases

22
TOXICITY
  • Hypervitaminosis D
  • causes hypercalcemia, which manifest as
  • Nausea vomiting
  • Excessive thirst polyuria
  • Severe itching
  • Joint muscle pains
  • Disorientation coma.

23
RICKETS
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