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VITAMIN, MINERAL & NUTRITION RELATED SYNDROMES

Minerals
  Copper deficiency
  Iron
  Selenium deficiency
Vitamins
  A: Retinoids
  B1: Thiamine
  B2: Riboflavin
  B12 deficiency
  Biotin
  D
  E
    Deficiency
    Intoxication
  Niacin
  Folate
  Pyridoxine
    Deficiency
    Intoxication
MULTIFACTORIAL
Alcoholism
Celiac disease
Critical illness polyneuropathy
Cuban neuropathy
Postgastroplasty (Bariatric surgery)
Strachan's

Also see
  GI disorders
  Toxic disorders
    Muscle
    Nerve


Vitamin & Toxic Disorders: Symptom features


Thiamine (B1) deficiency (beri-beri)
Thiamine
B1 Biochemistry
Deficiency
  Clinical
  Laboratory
Thiamine disorders


Riboflavin

Riboflavin (B2) related syndromes



Niacin
  (Nicotinic acid; Vitamin B3)
    Deficiency

Nicotinamide
  • Biochemistry
    • Niacin: Includes Nicotinic acid & Nicotinamide
    • Metabolically active forms
      • Nicotinamide adenine dinucleotide (NAD)
      • NAD phosphate (NADP)
    • Functions: Oxidation–reduction reactions
    • Associated enzymes carry out oxidation & reduction reactions
    • Sources: Meat, Liver, Fish, Legumes, Coffee & tea
  • Diet
    • Sources: Meat, Liver, Fish, Legumes, Coffee & Tea
    • Inhibitor: Leucine excess (Millet) blocks conversion of tryptophan to niacin
  • Pellagra
    • Causes
      • Reduced diet intake of niacin or tryptophan
      • Niacin deficiency: Isoniazid; Alcoholism
      • Associations
        • Hartnup's disease: Defective intestinal absorption of amino acids
        • Carcinoid syndrome: Conversion of tryptophan to serotonin by tumor
        • HIV infection
    • Clinical: DDD
      • Diarrhea
      • Dermatitis: Areas exposed to sunlight
      • CNS: Dementia; Hyperreflexia; Startle myoclonus; Insomnia; Fatigue
      • Tongue: Glossitis; Burning sensations
      • Neuropathy
        • Similar to Beri-Beri
        • ? Related to other associated vitamin deficiencies
        • Treatment: No response to niacin alone
    • Treatment
      • Niacin: 40 to 250 mg qd; Causes flushing
      • Nicotinamide: 100 mg po qid; Then 50 mg tid until skin lesions resolve
      • Children: Nicotinamide 10–50 mg orally every 6 hours


Pyridoxine intoxication
Pyridoxine


Pyridoxine deficiency 15


Vitamin B12 (Cobalamin) deficiency

Putnam
Causes
Clinical features
Testing

Vitamin B12


Vitamin E deficiency
Vitamin E (α-tocopherol)


Hypervitaminosis E

Vitamin D deficiency 5
1,25-Dihydroxy Vitamin D3


Biotin deficiency
Biotin


Retinoid (Vitamin A derivatives) toxicity

Cuban epidemic neuropathy 1

Bariatric surgery (Postgastroplasty) syndromes: Polyneuropathy +

Selenium Deficiency 3, 4

Copper Deficiency & Disorders





MRI: Copper Deficiency
Posterior column T2 signal

Copper deficiency: Acquired
Copper smelting: Associated with Arsenic toxicity


Copper-associated disorders: Inherited
Copper: Animal disorders
Iron Disorders

Folate deficiency: Neuropathy 14


Critical Illness Neuropathy
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Some illustrations from MW King

4/18/2016