Nutrional Disorders

Impaired night vision, blindness (squamous metaplasia of corneal epithelium; see Fig. 7-4A)
Follicular hyperkeratosis (loss of sebaceous gland function; see Fig. 7-4B), pneumonia, growth retardation, renal calculi

Pathologic fractures, excess osteoid, bow legs (see Fig. 7-4C)
Children: rickets; craniotabes (soft skull bones); rachitic rosary (defective mineralization and overgrowth of epiphyseal cartilage in ribs)

Hemolytic anemia (damage to RBC membrane)
Peripheral neuropathy, degeneration of posterior column (poor joint sensation) and spinocerebellar tract (ataxia)

Newborns: hemorrhagic disease of newborn (CNS bleeding, ecchymoses)
Adults: gastrointestinal bleeding, ecchymoses; prolonged prothrombin time and partial thromboplastin time

Papilledema and seizures (due to an increase in intracranial pressure), hepatitis, bone pain (due to periosteal proliferation

Hypercalcemia with metastatic calcification, renal calculi

vitamin K-dependent procoagulant factors; synergistic effect with warfarin anticoagulation

Hemolytic anemia and jaundice in newborns if mother receives excess vitamin K

Dry beriberi: peripheral neuropathy (demyelination)

Wernicke's syndrome: ataxia, confusion, nystagmus, mamillary body hemorrhage

Korsakoff's syndrome: antegrade and retrograde amnesia; demyelination in limbic system

Wet beriberi: congestive cardiomyopathy with biventricular failure

Corneal neovascularization, glossitis, cheilosis (cracked lips), angular stomatitis (fissuring at angles of mouth)

Pellagra: diarrhea, dermatitis (hyperpigmentation in sun-exposed areas; see Fig. 7-5A), dementia

Sideroblastic anemia (microcytic anemia with ringed sideroblasts; see Fig. 11-13), convulsions, peripheral neuropathy

Megaloblastic anemia, neurologic disease (posterior column and lateral corticospinal tract demyelination), glossitis

Megaloblastic anemia, with no neurologic disease (unlike vitamin B12), glossitis

Dermatitis, alopecia, lactic acidosis

Weak capillaries and venules, skin ecchymoses, perifollicular hemorrhage (ring of hemorrhage around hair follicles; see Fig. 7-5B), corkscrew hairs (see Fig. 7-5C), hemarthrosis, bleeding gums (see Fig. 7-5D), anemia (combined iron and folate deficiency)

Loosened teeth, glossitis, poor wound healing

Metabolic: impaired glucose tolerance, peripheral neuropathy

Blood: microcytic anemia (cofactor in ferroxidase)

Vessels: aortic dissection (weak elastic tissue)

Metabolic: poor wound healing (cofactor in lysyl oxidase)

Teeth: dental caries

Thyroid: thyroid enlargement (goiter), hypothyroidism

Muscle: muscle pain and weakness, dilated cardiomyopathy

Metabolic: poor wound healing (cofactor in collagenase)

Mouth: dysgeusia (cannot taste), anosmia (cannot smell), perioral rash

Children: hypogonadism, growth retardation