The following points highlight the six main diseases caused due to vitamin deficiency:- 1. Rickets 2. Osteomalacia 3. Scurvy 4. Beriberi 5. Pellagra 6. Pernicious Anemia.
Vitamin Deficiency: Disease # 1. Rickets:
Vitamin D deficiency causes the disease rickets in children.
a. It is characterised by bone deformities.
b. The earliest bony lesion is often craniotabes-small round unossified areas in the membranous bones of the skull.
c. Another early sign is the ‘beading’ at the costochondral junctions of the ribs known as ‘Rickety rosary’.
d. Later features are ‘Bogging’ of the frontal and parietal bones and delayed closure of the anterior fontanelle and deformities of the chest such as undue prominence of the sternum known as ‘pigeon chest’.
e. The bones are soft due to the non-deposition of calcium salts and hence they are easily bent by the weight of the body.
f. In case the rickets continue for two to three years, there is serious bone deformities such as bow legs, deformities of the spine and pelvis. There is extension and widening of the epiphysis at the growing points.
g. Renal ricket is caused by defective transport of phosphate by the renal tubules.
It can be prevented by the administration of vitamin D and calcium. Vitamin D in ordinary dose cannot cure the renal rickets and hence renal rickets are sometimes referred to as Vitamin D-resistant rickets.
Vitamin Deficiency: Disease # 2. Osteomalacia:
Vitamin D deficiency causes the disease osteomalacia in adults. It generally occurs in pregnant women of low income groups who consume a diet devoid of vitamin D and calcium and those who observe ‘purdct’ also. It is prevalent in India, Pakistan, Bangladesh, China and Middle-East countries.
a. The changes in the blood and bone are similar to those in rickets.
b. Progressive decalcification of bones— bones become soft.
c. Bone deformities occur in pelvis, legs, ribs, sacrum and lower lumbar vertebrae.
d. Owing to the deformity of the pelvis, normal delivery of the baby becomes difficult.
This disease can be prevented by the administration of vitamin D and calcium.
Vitamin Deficiency: Disease # 3. Scurvy:
Severe deficiency of ascorbic acid leads to the disease scurvy.
A. Scurvy in adults:
a. The first symptoms are weakness, easy fatigue and listlessness. These are followed quickly by pain in bones, joints and muscles of the extremities, shortness in breath.
b Hemorrhages in muscle occur particularly in calf, thigh and forearm. Hemorrhages may occur in joints with swelling and pain.
c. As the deficiency advances, the gums become swollen, blue red and spongy. The gums may be infected by bacteria. There is loss of teeth.
B. Infantile scurvy:
a. The prescorbutic infants become anorexic and listless for a few days.
b. With the beginning of the disease, the infant lies with legs drawn up on the abdomen.
c. The infant cries when touched especially when its legs or arms are moved or lifted.
d. Extreme tender swellings may be felt at the end of the long bones.
e. The sternum may sink slightly inward.
f. Purpura occurs in the skin.
g. If treatment is delayed, dyspnea, cyanosis, convulsions and death may occur.
a. The disease can be prevented by the administration of high dose of ascorbic acid.
b. Citrous fruits are to be taken regularly.
Vitamin Deficiency: Disease # 4. Beriberi:
The disease beriberi is caused by the deficiency of thiamine (vitamin B1).
There are three types of beriberi—wet beriberi, dry beriberi and infantile beriberi.
A. Wet beriberi:
a. The important feature of wet beriberi is edema.
b. It develops rapidly and not only the legs but also the face, trunk, serous cavities are involved.
c. The calf muscles are slightly swollen and tender on pressure.
d. Palpitation and breathlessness appear.
e. The diastolic blood pressure is low while the systolic is high.
f. The pulse is fast.
g. The heart becomes weak and death occurs as a result of heart failure.
B. Dry beriberi:
a. The muscles are progressively wasted and weak and difficult to walk.
b. The affected individual takes the help of sticks to stand and walk and, ultimately, he becomes bedridden.
c. The patient dies if untreated.
d. There is cerebral disorder.
C. Infantile beriberi:
a. Those infants will suffer from the deficiency of the vitamin whose mother’s breast milk contains low thiamine.
b. The infants face restlessness and sleeplessness.
c. Anorexia, vomiting and breathlessness develop.
d. Most of the symptoms are due to cardiac dilatation and failure.
e. Sudden death occurs if not treated with thiamine immediately.
The disease can be prevented by the administration of thiamine by intramuscular injection.
Vitamin Deficiency: Disease # 5. Pellagra:
a. The deficiency of niacin causes the disease pellagra.
b. It occurs whenever corn (maize) is the main diet and the corn protein is deficient in some of the essential amino acids, notably tryptophan and lysine. Hence, niacin is not formed in the body.
c. It is also caused by acute or chronic infection.
Pellagra is characterised by three Ds—dermatitis, diarrhoea and dementia.
a. The bright red erythema resembling sunburn occurs over the exposed parts of the body.
b. The commonest sites are the back of the fingers and hands, the forearms, dorsum of the feet and ankles and the neck.
c. At the onset, the skin becomes red and slightly swollen.
d. Secondary infection is always present.
e. The dermatitis is precipitated by exposure to sunlight.
1. In most cases, nausea and vomiting are found.
2. The diarrhoea ranges from few to several loose stools a day with blood and mucosa.
a. Dementia more frequently occurs in chronic cases.
b. Irritability, changes in disposition, depression, inability to concentrate are found in milder mental disturbances.
c. In mild cases, poor memory is common.
d. In chronic cases, spasticity, ataxia, the involvement of the bladder and rectal sphincters are seen.
a. Niacinamide in doses of 15-25 mg three times a day are to be prescribed.
b. Adequate quantities of meat, eggs, milk and vitamin B-complex are given.
c. Any accompanying infection should be treated with the proper antibiotic.
Vitamin Deficiency: Disease # 6. Pernicious Anemia:
The lack of ‘intrinsic factor’ in the stomach resulting in the failure of absorption of vitamin B12 causes the disease pernicious anemia.
a. The RBC count is low—1.5 to 2.5 million per cubic millimetre.
b. The average diameter of the cell is above normal.
c. Excessive destruction of the abnormal circulating red cells causes the increase in the serum bilirubin.
d. The hemoglobin content is as low as 8 to 9 per cent.
e. The nucleated red cells of the bone marrow is highly increased.
f. The cells of Stage I are peculiar and are called megaloblasts.
g. The cells of the stomach responsible for acid and enzyme secretions are atrophied. So the gastric secretions are devoid of acid, pepsin and intrinsic factor (IF).
h. The tongue is sored and inflamed.
i. Numbness and tingling occur in fingers and toes.
j. Signs of involvement of the spinal cord (vitamin B12 neuropathy) are observed.
k. In advanced cases, demyelination of the white fibres of the spinal cord occurs.
It can be prevented by the administration of vitamin B12.