Riboflavin deficiency disease

Introduction

Introduction to riboflavin deficiency Riboflavinosis (ariboflavinosis) is a syndrome characterized by scrotal inflammation, cheilitis, glossitis and angular cheilitis caused by lack or deficiency of flavin in the body. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: Eczema

Cause

Riboflavin deficiency

Riboflavin is an important component of the yellow protein coenzyme required for normal intracellular oxidation and reduction. It is closely related to the metabolism of fat, sugar and protein. Riboflavin is stored in tissues with limited amount and is quickly consumed. It is estimated that the daily human nutrient requirement is 0.6mg/4186.8J (1000 kcal). In the absence of it, it can cause a series of damages in experimental animals, but in humans it is mild, mainly causing skin and mucous membrane damage.

The reasons for riboflavin deficiency may be:

1 The supply in the diet is insufficient.

2 Eating habits suddenly change or improperly cooked and eaten.

3 pregnancy, heavy physical labor, etc., consumption increased, while the amount of riboflavin did not increase accordingly.

4 gastrointestinal diseases, hyperthyroidism, advanced cancer, chronic alcoholism, fever and chronic wasting diseases affect the absorption or increase of riboflavin; 5 oral contraceptives and other drugs, especially phenazines, tricyclic Antidepressants, boric acid, etc. can affect the metabolism of riboflavin, or interact with riboflavin to cause riboflavin deficiency.

Prevention

Riboflavin deficiency prevention

Remove the cause, give fresh food rich in riboflavin, such as animal liver, kidney, heart and milk, other brown rice, spinach, soybeans and eggs, systemic treatment of riboflavin orally, 10-15 mg daily, also Dry yeast and multivitamin B tablets can be used. Topical treatment of angular keratitis can be coated with 1% silver nitrate solution twice a day, or with 1% gentian violet, tin-like powder, Zhuhuang powder, etc. Scrotal dermatitis can be used as general dermatitis. Treatment of eczema treatment principles.

Riboflavin deficiency is also common in patients after gastrectomy and in patients with chloramphenicol or other antibiotics. It is effective to use a multivitamin B preparation for prophylactic treatment with a daily dose of 3 mg.

Eye surgery or trauma may cause the cornea to form blood vessels, so it is best to give riboflavin before the corneal surgery, especially if the patient has any signs of malnutrition, riboflavin in trachoma and blister keratitis It is also valuable in treatment.

Complication

Riboflavin deficiency Complications eczema

There are no special complications in this disease.

Symptom

Symptoms of riboflavin deficiency symptoms Common symptoms Lips dry mouth splitting papules lips licking tongue inflammation photophobia and tears oral mucosa pigmentation scarring corneal ulcer photophobia

The individual symptoms of riboflavin deficiency are not specific, but when comprehensively observed, the diagnosis of the disease can be prompted. These symptoms mainly include scrotal inflammation, glossitis, cheilitis and angular cheilitis.

(1) Scrotal inflammation is the earliest and most common manifestation, which can be divided into erythematous type, papular type and eczema type.

1. The erythema type is the most common, the early is reddish plaque, symmetrically distributed on both sides of the scrotum, the edges are bright red, the surface is covered with bright, sticky, grayish white or brown scales, and the edges are brown and black, and the scales are removed. The base is soft and non-wetting.

2. The early stage of papules is a large number of scattered needles. The large flat rounded papules of the soybeans are covered with tan and thin sputum. They can also be fused into a piece. In the early stage, only one side can be used, and the late stage can be symmetrically distributed on both sides of the scrotum.

3. Eczema-type scrotum limited or diffuse infiltration hypertrophy, lichenification, and the same as chronic eczema, may have exudate, crusting, inter- or cleft palate, chronic passage, long-term skin lesions can be extended to the inside of the penis or the inner thigh .

In addition to scrotal inflammation, oily scaly skin lesions such as seborrheic dermatitis can also occur in the center of the face, nasolabial folds, nose, inside and outside the eyelids, and in the earlobe.

(2) In the early stage of tongue inflammation, the braided nipple is the size of the tip of the needle. The contoured nipple is a thick papule with a size of soybean. The middle part of the tongue has a sharp red spot. The front end is wide and the back end is narrow and gourd-like. The heavy tongue is blue and purple, and the swelling is obvious. It becomes smaller or disappears, and the tongue surface is smooth and atrophy, accompanied by cracks of different sizes and shades, and it is consciously painful.

(C) cheilitis is mainly seen in the lower lip, dry and desquamation of the lips and pigmentation, occasionally flushing, erosion, longitudinal cracking.

(D) keratitis horn impregnation whitish, smashed, chapped and knotted, tend to infection, the more can be scarred.

Other mucosal symptoms include photophobia, tearing, conjunctivitis, superficial keratitis, corneal opacity and even ulceration, nasal vestibular scab, and cleft palate.

Examine

Examination of riboflavin deficiency

(1) Pathological examination: the epidermis of the scrotal skin lesions is significantly keratinized, and the granular layer is reduced or disappeared. In severe cases, except for hyperkeratosis of the epidermis, the pigmentation of the primary cells is reduced or disappeared, and the capillaries in the dermis have different degrees of expansion, lips. The epithelium of the tongue also saw keratinization, and the tissue of the tongue nipple was also atrophied.

(B) Determination of urinary riboflavin: expressed in grams per gram of creatinine. For diagnostic reliability, it is best to collect a 24-hour urine test. Results <27 g / gram of creatinine, suggesting vitamin B2 deficiency in adults. Children are higher than adults.

(C) urinary excretion load test: oral loading dose of riboflavin 5mg, collected 4 hours urine to measure excretion. Adult excretion <1000g is riboflavin deficiency.

(IV) Red blood cell glutathion reductase (EGR) function test: This test was selected clinically as the latest and simple method for evaluating the nutritional status of vitamin B2. The test was based on the "FAD effect". After adding FAD, the enzyme activity increased by more than 20%, suggesting that the riboflavin storage in the tissue is insufficient.

Diagnosis

Diagnosis and identification of riboflavin deficiency

According to the clinical characteristics of scrotal inflammation, glossitis, etc., combined with dietary history and other diagnosis is not difficult, if there is doubt, the test can be confirmed after a few days, the necessary fashion can be used for blood riboflavin determination.

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