What is ariboflavinosis? Why is it important to know?

Ariboflavinosis

Ariboflavinosis is the medical condition caused by deficiency of riboflavin (vitamin B2). Ariboflavinosis is most often seen in association with protein-energy malnutrition, and also in cases of alcoholism.

It was originally known as pellagra sin pellagra, as it exhibits certain similarities to the niacin deficiency pellagra.

The most common cause of riboflavin deficiency is an inadequate diet; thus, it occurs most frequently in populations consuming limited quantities of riboflavin-containing foods such as meats, eggs, milk, cheese, yogurt, leafy green vegetables and whole grains. Riboflavin deficiency can also occur in those with impaired liver function, which prevents proper utilization of the vitamin.

Borderline riboflavin deficiency as a consequence of certain anti-retroviral medications has also been known to cause acute lactic acidosis.

The signs and symptoms of riboflavin deficiency typically include sore throat with redness and swelling of the mouth and throat mucosa, cheilosis and angular stomatitis (cracking of the lips and corners of the mouth), glossitis (magenta tongue with atrophy), seborrheic dermatitis or pseudo-syphilis (moist, scaly skin particularly affecting the scrotum or labia majora and the nasolabial folds), and a decreased red blood cell count with normal cell size and hemoglobin content (normochromic normocytic anemia).

Riboflavin deficiency is usually found together with other nutrient deficiencies, particularly of the other water-soluble vitamins. Phototherapy to treat jaundice in infants can cause increased degradation of riboflavin, leading to deficiency if not monitored closely. Persons with chronic alcoholism can have impaired absorption of riboflavin and other vitamins such as thiamine (Wernicke's encephalopathy).

One study of pregnant women has found that riboflavin-deficient women were 4.7 times more likely to develop preeclampsia, though the mechanism for this is not known.

Subclinical riboflavin deficiency occurs in:

1. Women taking oral contraceptives.

2. The elderly.

3. People with eating disorders.

4. Disease states such as HIV, inflammatory bowel disease, diabetes and chronic heart disease.

The fact that riboflavin deficiency does not immediately lead to gross clinical manifestations indicates that the systemic levels of this essential vitamin are tightly regulated.

Subclinical riboflavin deficiency in children.

Although the effects of long-term sub-clinical riboflavin deficiency are unknown in children, this deficiency has been proven to result in reduced growth.

Riboflavin Deficiency in animals

In animals, riboflavin deficiency results in lack of growth, failure to thrive, and eventual death. Experimental riboflavin deficiency in dogs results in growth failure, weakness, ataxia, and inability to stand. The animals collapse, become comatose, and die. During the deficiency state, dermatitis develops together with hair-loss.

Post-mortem studies in rhesus monkeys fed a riboflavin-deficient diet revealed that about one-third the normal amount of riboflavin was present in the liver, which is the main storage organ for riboflavin in mammals. These overt clinical signs of riboflavin deficiency are rarely seen among inhabitants of the developed countries.

About 28 million Americans exhibit a common 'sub-clinical' stage characterized by a change in biochemical indices (e.g. reduced plasma erythrocyte glutathione reductase levels).




Summary


Riboflavin deficiency (ariboflavinosi):

Riboflavin is continuously excreted in the urine of healthy individuals, making deficiency relatively common when dietary intake is insufficient. However, riboflavin deficiency is always accompanied by deficiency of other vitamins. Riboflavin deficiency may be primary or secondary.
.
A. Primary deficiency of riboflavin occurs when there are poor vitamin sources in one's daily diet.
B. Secondary deficiency of riboflavin may be the result of conditions that affect absorption in the intestine, the body not being able to use the vitamin, or an increase in the excretion of the vitamin from the body.

Signs and symptoms of riboflavin deficiency (ariboflavinosis)
1. Cracked and red lips, inflammation of the lining of mouth and tongue, mouth ulcers, cracks at the corners of the mouth (angular cheilitis), and a sore throat.
2. Dry and scaling skin, fluid in the mucous membranes.
3. The eyes may become bloodshot, itchy, watery and sensitive to bright light.

4. Oral-ocular-genital syndrome

Riboflavin deficiency is classically associated with the oral-ocular-genital syndrome. Angular cheilitis, photophobia, and scrotal dermatitis are the classic remembered signs.

5. Other signs of deficiency include corneal opacity, lenticular cataracts, hemorrhagic adrenals, fatty degeneration of the kidney and liver, and inflammation of the mucus membrane of the gastrointestinal tract.



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