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As a doctor today I prescribe Riboflavin (Vitamin B2) rich foods to prevent mucocutaneous and ocular lesions

Dr Sampurna Roy MD     

 

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Riboflavin Deficiency related lesions (Ariboflavinosis)

 

Lips:

                                        

Cheilosis (swelling and fissuring of the lips).

Mouth:

                                        

Angular stomatitis (cheilitis) is inflammation at the angles of the mouth. There are cracks in the skin which may be painful and often infected.

Histologically, there is hyperkeratosis and a mild scattering of mononuclear infiltrate in the dermis.

Facial skin:

                                                 

There is seborrheic dermatitis of the facial skin. 

The lesion usually involves cheeks , areas behind the ears and vulva.

Tongue:

                                  

There is redness and irritation of the tongue.It is magenta in colour (glossitis) and is due to atrophy of the mucosa.

Eye lesions :

                                              

The cornea is initially vascularized by numerous sprouting capillaries.

This is followed by opacification of the cornea. Finally there is ulceration.

The most serious lesion is interstitial keratitis of the cornea.

The conjunctivae are injected and severe photophobia is a problem.

 

 

Riboflavin was isolated in 1933 and synthesized in 1935.

Historically, it was the first Vitamin to be identified as a constituent of an enzyme system.

It forms the prosthetic group of several flavoprotein enzymes, including the yellow respiratory enzyme "Warburg", now known as cytochrome oxidase, which together with cytochromes, forms an enzyme system of great importance in cellular respiration.

Riboflavin originates from the Latin word "Flavus" meaning yellow.

Diets of rural children indicate large deficits in micronutrient intake, mainly of folic acid, riboflavin and iron.

Foods rich in Riboflavin (VitaminB2)  include  nuts, meat, fish, eggs milk, cheese, mushroom, almond, grains and spinach.

Riboflavin is important for the synthesis of flavin nucleotides, which play an important role in electron transport and other reactions in which the transfer of energy is crucial.

Riboflavin is converted within the body to flavin mononucleotides and dinucleotides.

Riboflavin itself and flavin mononucleotides are absorbed from the proximal small bowel, where as flavin adenine dinucleotide is degraded to flavin mononucleotide prior to absorption.

The conjugated and unconjugated forms circulate bound to serum proteins. 

Symptoms due to riboflavin deficiency is rare.

 It is usually noted in ill patients suffering from a variety of diseases and in some cases noted in malnourished alcoholic patients.

Riboflavin deficiency is uncommon in developing countries because bread and cereals are fortified with this vitamin.

Sometimes mild riboflavin deficiency is noted in pregnancy and lactation. It may also occur in growing children and adolescence due to increased demand and moderate nutritional deficiency.

Summary:

-Riboflavin is a constituent of many foods and is a component of several enzymes that play a vital role in metabolism.

-Mucocutaneous lesions are present in both acute and chronic riboflavin deficiency.

-The distribution of the lesions varies with the age and gender of the patient.

-Lesions of acute riboflavin deficiency are similar to those noted in protein-energy malnutrition of the kwashiorkor type. Patient is usually anemic.

-An early sore mouth become macerated and later develop crack (angular stomatitis) lips become sore (glossitis).

-A scaly dermatitis, resembling seborrheic dermatitis, develops later and affects the face, scrotum and vulva.

-Ophthalmic lesions are present in some cases.

-Riboflavin deficiency may occur in a pure form or in patients with pellagra or multiple deficiencies.

 

Visit: Pathology of Vitamin A deficiency: Importance of Vitamin A in our daily diet

Visit: As a doctor today I prescribe Thiamine  (Vitamin B1) rich foods :Prevent Beriberi,Wernicke’s Encephalopathy, and Korsakoff’s Psychosis.

Visit: As a doctor today I prescribe Niacin (Vitamin B3) rich foods to eradicate Pellagra - Prevent the 4 Ds - Dermatitis ; Diarrhea ; Dementia and Death

Visit: Eat Citrus Fruits everyday and keep Scurvy away - Pathology of Vitamin C Deficiency

Visit: As a doctor today I prescribe Vitamin K to prevent hemorrhage -The most important health problem of Vitamin K deficiency is Hemorrhagic Disease of the Newborn

Visit: As a doctor today I prescribe nutritious food for every hungry child  

 

Further reading:

Thiamin, riboflavin and vitamin B6: impact of restricted intake on physical performance in man

Prevalence of riboflavin deficiency among Guatemalan elderly people and its relationship to milk intake

Effect of physical activity on thiamine, riboflavin, and vitamin B-6 requirements

The thiamin, riboflavin and pyridoxine status of patientson emergency admission to hospital

Riboflavin deficiency

Interrelationship between thiamine and riboflavin in the liver

Riboflavin deficiency in man

The clinical manifestations of nicotinic acid and riboflavin deficiency (pellagra)

Riboflavin, flavin mononucleotide, and flavin adenine dinucleotide in human plasma and erythrocytes at baseline and after low-dose riboflavin supplementation

Riboflavin status in pregnancy

The biosynthesis of riboflavin in man

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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)

 

 

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