Name
PYRIDOXINE DEFICIENCY
DESCRIPTION
DETAIL
CAUSES : 1. MALNUTRITION 2. REDUCED ABSORPTION : - ELDERLY - INTESTINAL DISEASE - INTESTINAL SURGERY 3. ENHANCED CLEARANCE - BY LIVER DISORDERS LIKE HEPATITIS - MEDICATIONS 4. INCREASED BREAKDOWN - CONDITIONS ASSOCIATED WITH INCREASED ALK PHOSPHATASE LEVELS 5. PYRIDOXINE RESPONSIVE MICROCYTIC HYPOCHROMIC ANEMIA ( IE, SIDEROBLASTIC ANEMIA ) 6. ISONIAZID & CERTAIN MUSHROOM INDUCED DEFICIENCY 7. LOW MATERNAL PYRIDOXINE LEVELS AS WELL AS EXCESSIVE SUPPLEMENTATION MAY RESULT IN PYRIDOXINE RESPONSIVE SEIZURES IN INFANT -------------------------------------------------------------------------- D.D. : - ANEMIA - BERIBERI - FOLIC ACID DEFICIENCY - MALABSORPTION - PORPHYRIA, ACUTE INTERMITTENT - HOMOCYSTINURIA - HOMOCYSTINEMIA - ISONIAZID TOXICITY - PELLAGRA - NEONATAL SEIZURES * SERUM PLP ( PYRIDOXAL 5- PHOSPHATE ) LEVELS - REDUCED * URINARY 4-PYRIDOXIC ACID LEVELS ( NORMAL: 128 - 680 NMOL PER NMOL OF CREATININE. THE LEVELS ARE LOWER IN FEMALES THAN MALES & ARE REDUCED IN VIT B1 DEFICIENCY ) - REDUCED * ELECTROENCEPHALOGRAM FINDINGS IN NEONATES & INFANTS WITH PYRIDOXINE DEPENDENT SEIZURES ARE CHARACTERISED BY REPETITIVE RUNS OF HIGH VOLTAGE, GENERALIZED, BILATERAL SYNCHRONOUS 1 TO 4 HZ SPIKES & SHARP WAVE BURSTS. * NORMALIZATION OF ELECTROENCEPHALOGRAM OR CAUSING CLINICAL CESSATION OF SEIZURES BY INJECTING 100 MG OF I.V. PYRIDOXINE IDENTIFIES PYRIDOXINE DEPENDENT & PYRIDOXINE RESPONSIVE SEIZURES.
TYPENOTES
" Supplementation of pyridoxine hydrochloride in various medical conditions is as follows: " o Cirrhosis - 50 mg/d o Hemodialysis - 5-50 mg/d o Peritoneal dialysis - 2.5-5 mg/d o Chronic renal failure - 2.5-5 mg/d o Sideroblastic anemia - 50-600 mg/d o Pyridoxine-dependent seizures - 100 mg/d o Homocystinuria - 100-500 mg/d o Homocystinemia - 100-500 mg/d o Gyromitra poisoning - 25 mg/kg IV Diet " Pyridoxine is widespread in foods. Rather robust quantities can be found in meats, particularly liver, fish, and chicken; vegetables, particularly beans, peas, and tomato; fruits, such as oranges, bananas, and avocados; and grains, such as enriched breads, cereals, and grains. " " Some vegetables contain up to 70% biologically unavailable pyridoxine as pyridoxine-5-glucoside. " " Some heat-treated foods may contain pyridoxine-lysine, which has antivitamin activity. " " The minimum daily requirement is approximately 1.5 mg; however, the recommended daily intake by the US National Research Council is 2 mg for adults and 0.3 mg for infants. Activity " Vigorous exercise results in a transient increase in plasma PLP, probably from the release of muscular glycogen phosphate. Carbohydrate loading prior to exercise reduces this response. Within 30 minutes of discontinuing exercise, PLP levels return to normal. DRUG TREATMENT : 1. VITAMINS : - PYRIDOXINE
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, SERUM FOLATE, SERUM B12