Women deficiency

A dietary deficiency of calcium can lead to osteoporosis, a disease in which bones are insufficiently mineralized and consequently are fragile and easily fractured. Osteoporosis is a particularly common problem among elderly women. Deficiency of phosphorus results in bone loss along with weakness, anorexia, malaise, and pain. Iron deficiencies lead to anemia, a decrease in the concentration of hemoglobin in the blood. 

Glutaric aciduria type II, which is a defect of P-oxida-tion, may affect muscle exclusively or in conjunction with other tissues. Glutaric aciduria type II, also termed multiple acyl-CoA dehydrogenase deficiency (Fig. 42-2), usually causes respiratory distress, hypoglycemia, hyperammonemia, systemic carnitine deficiency, nonketotic metabolic acidosis in the neonatal period and death within the first week. A few patients with onset in childhood or adult life showed lipid-storage myopathy, with weakness or premature fatigue [4]. Short-chain acyl-CoA deficiency (Fig. 42-2) was described in one woman with proximal limb weakness and exercise intolerance. Muscle biopsy showed marked accumulation of lipid droplets. Although... 

Women with secondary amenorrhea (i.e., cessation of menses in a woman who was previously menstruating for 6 months or more) who have been estrogen deficient for 12 months or longer should also receive low-dose estrogen initially, but the dose can be increased up to maintenance levels... 

A 27-year-o d woman with epilepsy has been taking phenytoin to control her seizures. She is now pregnant, and her physician is considering changing her medication to prevent potential bleeding episodes in the in nt. What biochemical activity might be deficient in the infant if her medication is continued ... 

Answer A. Pregnant woman with megaloblastic anemia and elevated serum homocysteine strongly suggests folate deficiency. Iron deficiency presents as microcytic, hypochromic anemia and would not elevate homocysteine. deficiency is not most likely in this presentation. 

If a pregnant woman is affected by mercury poisoning, the consequences may affect the child. As a result, the child may suffer from profound mental deficiency, atrophy of cerebral cortex, commisure and cerebellum neuron destruction. Acrodynia is a syndrome that affects children exposed to organic and inorganic mercury compounds. Symptoms include itchy, measles-like rash followed by desquamation of palm and foot skin, essential tachycardia, generalized swellings, hypertension and salivation (Harada, 1995). 

For mild anemia, the determination of red cell indices has some value in diagnosis however, it should be realized that these indices may appear to be entirely normal and that they are subject to errors. Patients with statistically normal hemoglobin values may show a positive hemoglobin response to iron therapy. A woman with hemoglobin concentration of 13g (100 ml)-1 may be iron deficient through excessive menstrual flow for her a hemoglobin concentration of 15g (100 ml)-1... 

A 47-year-old woman weighing 59 kg took acarbose 50 mg tds. Her blood glucose improved but she lost about 1 kg/month. She had a sore tongue without oral ulcers and no evidence of malabsorption. Later she developed general weakness and iron deficiency anemia but no other evidence of malabsorption. After she had lost 7 kg in 5 months, acarbose was withdrawn. Her complaints disappeared, her weight normalized, and she had no signs of iron deficiency anemia, even without iron therapy. 

Choline deficiency developed in a 41-year-old woman with advanced cervical cancer who underwent prolonged parenteral nutrition (915). Her liver function tests became abnormal and she became jaundiced and complained of nausea and vomiting. The serum choline concentration was 5.77 mmol/1 and there was histological evidence of hepatic steatosis. There was steady improvement with oral choline supplementation, 3 g/ day, and with oral glutamine 15 g/day. There was a 45% improvement in serum choline concentration over baseline. 

Cholestasis occurred in a woman with alpha-1 antitrypsin deficiency (phenotype PiZZ) who had taken prochlorperazine 5-10 mg qds for 27 months (3). She developed jaundice and ascites. Liver biopsy confirmed diffuse advanced chronic cholestasis, moderate portal and periportal inflammation, and bridging necrosis. Her liver function tests normalized within days of withdrawal of prochlorperazine. 

Iron deficient or pregnant woman absorbs about 30% of dietary iron. 

FIGURE. 18 FIGLU exCrelicn in a healthy woman O) and a folate-deficient pregnant woman ( ). (Redrawn with permission from Ghanarin it a .,... 

Vitamin B12 deficiency has been reported in a 78-year-old non-vegetarian white woman with gastro-esophageal reflux who had taken H2 receptor antagonists and omeprazole for 4.5 years (9). 

An 80-year-old Japanese woman presented with epigastric discomfort and nausea. She had a history of hypertension, rheumatoid arthritis, iron deficiency anemia, chronic renal insufficiency, and had taken oral ferrous sulfite for 19 months. Endoscopic examination of the duodenum showed marked pigmentation of the duodenal mucosa. Histological examination showed that the pigment had histochemical features compatible with hemosiderin and was located mainly within macrophage lysosomes in the lamina propria. Ferrous sulfite was withdrawn and the pigmentation disappeared within 7 months. 

A 34-year-old woman developed jaundice 11 days after starting to take omeprazole for ulcer dyspepsia (19). Her hver function tests suggested acute hepatitis with large rises in transaminases. Investigations excluded virus infections, autoimmune disorders, copper overload, and alphai antitrypsin deficiency. On withdrawal of omeprazole, the transaminases gradually normalized. 

Garrett JV, Hallum J, Scott P. Urinary antiseptics causing haemolytic anaemia in pregnancy in a West Indian woman with red cell enzyme deficiency. J Obstet Gynaecol Br Commonw 1963 70 1073-5. 

---