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Endocrinology

Hyporiboflavinosis and ariboflavinosis

Hyporiboflavinosis and ariboflavinosis — the morbid conditions resulting from deficit in an organism of Riboflavinum (B2) and which are shown damage of a mucous membrane of a mouth, an eye, skin.

Epidemiology
The ariboflavinosis in the developed countries meets very seldom. Hyporiboflavinoses meet in all countries, is frequent at a viral hepatitis, a chronic coloenteritis, cirrhosis, alcoholism, a thyrotoxicosis, a burn disease, etc. Deficit of B2 vitamin is quite often observed at chronic often recurrent conjunctivitis, keratoconjunctivites, blepharites, dermatitis, cracks of skin of fingers, nipple cracks at women, trophic ulcers, etc.

Pathogeny
B2 vitamin participates in synthesis of coenzymes of flavin oxyreductases (important system of yellow respiratory enzymes), coenzymatical forms of a pyridoxine, Folacinum, is a part of rhodopsin. Deficit of B2 vitamin causes a hypoxia of cells of various fabrics.

Classification
There is no standard classification.

Approximate formulation of the diagnosis:
1. Ariboflavinosis (primary, exogenous); a fliktenulezny keratitis, conjunctivitis, a cheilosis, a glossitis, seborrheal dermatitis in hands and a crotch.
2. Hyporiboflavinosis (food), angular stomatitis.
3. Chronic coloenteritis, hyporiboflavinosis (secondary), cheilosis, angular stomatitis, catarral conjunctivitis.

Preliminary diagnosis
Precursory symptom of an ariboflavinosis — the angular stomatitis ("perleches") which is shown tarnishing of a mucous membrane, maceration, small crusts in the field of mouth corners. The cheilosis — reddening of a border of a mucous membrane of lips with cross striation, cracks and their small swelling is characteristic. The glossitis which is shown a burning sensation in language, its reddening, more accurate drawing of nipples in the beginning and then is quite often observed by forming of "the polished language".

Verification of the diagnosis
The diagnosis is confirmed by decrease in excretion of Riboflavinum with urine to 100 mkg/days and below (it is normal of 300 — 1000 mkg/days), and also reduction of content of B2 vitamin in blood serum, erythrocytes and leukocytes.

The ariboflavinosis is differentiated from a pellagra, to a spr, a kwasiorkor, an iron deficiency anemia. The pellagra having similar damages of skin differs in psychological frustration and a diarrhea. To Spr it is characterized by the exhausting diarrhea and the expressed anemia. In hard cases of an ariboflavinosis anemia is quite often observed, but unlike iron deficiency it is more often normo-or hyperchromic and macrocytic. The kwasiorkor strikes mainly children of early age, differs from an ariboflavinosis of dispigmentatsiy skin, a diarrhea, increase and consolidation of a liver.

Treatment and prevention
Appoint the rational diet enriched with B2 vitamin. In addition at hyporiboflavinoses usually appoint in 5 — 10 mg of Riboflavinum for 2 — 3 weeks. Similar courses are conducted with the preventive purpose. At ariboflavinoses the dose of drug is raised to 10 mg of 3 — 5 times a day and increase treatment duration. In case of disturbance of absorption or digestion of B2 vitamin parenteral administration of drug is more preferable. Riboflavinum finds application in complex therapy of patients with a number of skin, ophthalmologic and internal diseases.

 
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