Vitamin e deficiency 2021

Vitamin E deficiency

1. Vitamin E (alpha-tocopherol)
deficiency
Prof. Imran Iqbal
Fellowship in Pediatric Neurology (Australia)
Prof of Paediatrics(2003-2018)
Prof of Pediatrics Emeritus, CHICH
Prof of Pediatrics, CIMS
Multan, Pakistan

2. Al-Quran suraAlRahman55:8-13

3. Clinical Scenario

4. Child with prolonged jaundice
•A 3 year old child presented with falling tendency for the last
three months. Previously child had normal neurological
development
•Mother says that child is having yellow eyes and pale stools since
first month of age
•On examination, child has jaundice. Liver is palpable by 3 cm
below the costal margin.
•Neurological examination shows ataxia, which is increased by
closing the eyes (positive Romberg sign) and absent deep tendon
reflexes.
•Diagnosis is Chronic Liver Disease and Vitamin E deficiency due to
fat malabsorption
•Child improves on starting daily doses of Vitamin E

5. Functions of Vitamin E (alpha-tocopherol)
•Maintains integrity of Cell Membranes
•Needed for myelination of nerves and nerve
impulse conduction
•Prevents damage from free radicals
•Anti-oxidant activity

6. Clinical Features of Vitamin E deficiency
•Hemolytic Anemia in premature infants
•Neuropathy and Ataxia in children and adults

7. Diagnosis
•Clinical presentation
•Serum Vitamin E level

8. Etiology of Vitamin E deficiency
•Sources of Vitamin E –vegetable oils, nuts
•Daily Requirement = 7 -15 mg / day
•Vitamin E is a fat soluble vitamin
•Vitamin E deficiency develops in the presence of
Fat malabsorption

9. Epidemiology of Vitamin E deficiency
•Vitamin E is stored in body and its deficiency is rare.
Vitamin E deficiency can develop in:
•Premature infants receiving unfortified milk
•Chronic Liver Disease with cholestasis
•Fat malabsorption

10. Treatment of Vitamin E deficiency
•Daily dose of Vitamin E is given
•DOSE : 25 –50 mg / day
•In Chronic Liver Disease and Fat Malabsorption
states, daily dose of Vitamin E is needed

11. Prevention of Vitamin E deficiency
•Adequate Vitamin E intake by mothers
•Fortified milk formula
•Adequate fat intake for infants and children
•Multiple micronutrient sachet from 6 months to 5
years of age