Showing posts with label signs. Show all posts
Showing posts with label signs. Show all posts

Hypomagnesemia symptoms - Hypomagnesemia pathophysiology

› › › Hypomagnesemia symptoms

What are the symptoms of hypomagnesemia?

Hypomagnesemia is a condition of magnesium deficit with below normal levels (less than 0.7 mmol/L) of the mineral in the blood.
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The very early hypomagnesemia may be asymptomatic and minor symptoms like general weakness and lack of appetite may go unnoticed. Common symptoms of blood magnesium (Mg2+) deficiency include anorexia, nausea, muscle weakness, cramps, tremors, dyspnea, hypertension, palpitations, arrhythmia, anxiety, confusion, personality changes and convulsions. Severe untreated hypomagnesemia may cause acute cardiac arrhythmia and sudden cardiac arrest, pulmonary arrest and death.

The common include, nutritional and metabolic disturbances, hypercalcemia, malnutrition, starvation, malabsorption, celiac disease, Crohn syndrome, ulcerative colitis, chronic diarrhea, polyuria, renal ailments, endocrine disturbances, alcoholism and certain medications. Hypomagnesemia may occur in conjunction with other electrolyte disturbances like hypoalbuminemia, hypophosphatemia and hypokalemia. Diagnosis is usually done by analyzing the total blood Mg2+ levels. Oral or intravenous magnesium supplementation is the standard treatment option.

Electrolyte disturbances in hypomagnesemia

Blood Mg2+ deficit has a direct effect on the calcium (Ca), potassium (K), and sodium (Na) channels. As Mg has inhibiting effect on the potassium channel efflux, hypomagnesemia may lead to increased potassium efflux from the body and cause hypokalaemia.

Mg2+ is an inhibitor of release of calcium from sarcoplasmic reticulum stores found in the myocytes.
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Sarcoplasmic reticulum plays a major role in the excitation-contraction coupling function of muscles. The blocking of the release of calcium can lead to cascading effects on parathyroid hormone release and hypocalcemia. Hypomagnesemia may affect bone turnover and with the concurrent onset of hypocalcemia, bone loss may occur.

Neuromuscular symptoms of hypomagnesemia

Hypomagnesemia affects the excitation-contraction coupling function of muscles. There is also lack of balance between irritating sodium and potassium ions and sedative calcium and magnesium ions. These malfunctions can trigger an increase in the excitability of muscles and nerves and vasospastic disorders.

Hypomagnesemia leads to numbness and tingling in arms and legs, convulsions, muscle cramps, muscle spasms and tremors, extensor plantar reflex, nystagmus (abnormal eye movements), epileptic fits and tetany. For the same reasons there is increase in reflexes (hyperreflexia) and muscle weakness. Bronchoconstriction is calcium-mediated. In hypomagnesemia, antagonizing the function of calcium, bronchodilation takes place with the relaxation of bronchial smooth muscle. Neurological manifestations include numbness, confusion, disorientation, irritability, insomnia, hallucinations, restlessness, psychosis, mood disorders, loss of interest, gloom, despondency, low spirits, aggression and depression.

Cardiovascular symptoms of hypomagnesemia

Blood Mg2+ depletion and the resultant hypomagnesemia can impair the sodium-potassium pump of cardiac cell membranes. There is increased loss of potassium from the cardiac cells and their action potential is shortened which may lead to cardiac arrhythmia and tachycardia. In ailments like coronary artery disease, arterial atherogenesis, arterial thrombogenesis, atherosclerosis and hypercholesterolemia one of the common denominator is hypomagnesemia.
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The decrease in serum levels of the mineral causes a decrease in its intracellular level. This leads to increased intracellular calcium content. The increased concentration of calcium (Ca2+ ions) within vascular smooth muscle cells activates actin-myosin contractile proteins leading to increase in vascular tone, vasoconstriction and total peripheral resistance. Thus hypomagnesemia results in hypertension. The administration of Magnesium supplement helps in controlling preeclampsia, a hypertensive syndrome of pregnancy.
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Lichodziejewska B et al in their study, "clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation", have concluded that low serum magnesium is suspected for the pathogenesis of the symptoms of mitral valve prolapse syndrome (MVP).
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References:
1.Assadi F. Hypomagnesemia: an evidence-based approach to clinical cases. Iran J Kidney Dis. 2010 Jan;4(1):13-9.
2.Dietary Supplement Fact Sheet. National Institutes of Health.
http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
3.Lichodziejewska B, Kłoś J, Rezler J, Grudzka K, Dłuzniewska M, Budaj A, Ceremuzyński L. Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation. Am J Cardiol. 1997 Mar 15;79(6):768-72.
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Zinc deficiency -Signs and symptoms


The symptoms of zinc deficiency vary widely among individuals. Zinc insufficiency manifest with multifarious indications based on the level of shortfall, food habits, gender of the patient, age group, general health status and presence of other diseases.
Insufficiency of zinc progressively affects all the organ systems.
Growth retardation and weight loss
If the insufficiency is during pregnancy, the newborn shows  birth defects and low birth weight. There is retarded physical and mental growth in affected children. Stunted growth, bowed limbs, dwarfism, scoliosis, pectus excavatum and poor reproductive growth are observed in children.
Impairment of cognitive and motor function
In adults, cognitive impairment, memory impairment, attention deficits, sleep problems and generalized disorganization of behavior are observed. In children learning of motor skills and memory functions are affected.
Decreased appetite
Anorexia or decreased appetite is among the initial indication of insufficiency. As anorexia and decreased food intake are causes of deficiency, a vicious cycle gets created.
Decreased sense of taste and smell
Zinc is necessary for the growth, development and function of taste and smell sensors and receptors.
The impairment of smell and taste senses is found to reverse with supplementation.

Diarrhea
Frequent diarrhea and stomach infections are symptoms of zinc deficit.
In the third world, zinc and ORS are of top priority in child patients suffering diarrhea, as invariably they show deficit of this trace mineral.

Degenerative diseases
Rapid progress in age related macular degeneration (AMD) and age-related eye disease (ARED) and loss of visual acuity are encountered.
Night blindness, myopia and photophobia may be due to zinc deficit.

Impaired reproductive system
Zinc insufficiency symptoms in women include defective, late and retarded growth of primary and secondary reproductive developments. Smaller breasts, narrow hips, disturbance of menstrual periods, fertility problems, pre-eclampsia in pregnancy and pre-menstrual syndrome are some of the effects.
Zinc deficiency indications in men include hypogonadism, defects in testes, defective primary and secondary reproductive development, fertility problems, loss of libido, impotence and aspermia.

Depression in immune functions
Production of antibodies declines and there is impaired function of T-lymphocytes, neutrophils and macrophages. There is marked increase in infections especially of the respiratory system.
Frequent attacks of flue and cold are observed. There is increased susceptibility to infections like pneumonia and there is increased allergic sensitivity.

Skin ailments
Frequent incidences of skin ulcers, acne, dermatitis, dry skin rash, psoriasis and eczema are symptoms of zinc deficiency.
Wounds get easily infected and take longer time to heal.
White spots and transverse lines on nails are zinc deficiency symptoms. Hangnails, inflammation of nail cuticles, nail infections, brittle nails, thin nails and poor nail growth are also observed. Hair loss (Alopecia) and dandruff are found to resolve with supplementation.

Enlargement of the prostate gland
Prostate gland has high concentration of zinc and benign enlargement of prostate gland and the resultant increased frequency of urination or inability to urinate are telltale warnings of shortage of the mineral.

Auto-immune diseases
The presence of auto-immune diseases like rheumatoid arthritis and multiple sclerosis may be indications for underlying persistent shortage.

Psychological disorders
Psychological disorders and emotional disturbances like frequent mood changes, depression, sudden fright, low self-esteem, eating disorders, schizophrenia and emotional instability are some symptoms encountered in individuals with deficit in intake of this trace mineral.
It is easy to treat this deficit with supplements and when treated early, it is possible to resolve all zinc deficit symptoms.

Current topic : Symptoms of zinc deficiency
Leukonychia - White spots on nails are zinc deficit indications

Alopecia (hair loss) - symptoms of zinc deficiency

hangnails - zinc deficiency symptoms

image credit: RickP
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Rickets signs and symptoms in children

Home > Rickets - Symptoms - Signs
The most important rickets symptoms and signs are bone deformity and pain in the bone
A number of skeletal, muscular and dental symptoms are observed in children in this disease.

Early rickets symptoms and signs

The initial symptoms are poor sleep, restlessness, profuse sweating in the head even in winter.
Then digestive disorders like unnaturally high appetite, stomach upsets, diarrhea and bloated abdomen can be seen as further rickets signs.
The patient's feeling of weakness, dullness, loss of weight, getting easily tired, and complains of pain in the bones, joints and muscles are tell-tale rickets symptoms.

Further signs of rickets

The bodies of the affected children become flabby and their muscles becoming flabby and weak. These children have unhealthy skin, sometimes with offensive smell, which can get infected easily causing secondary problems.
The rickets affected may suffer from tetany (uncontrolled muscle spasm) and seizures. Low levels of serum calcium causes tetany.
The ends of the ribs get enlarged and resemble beads (rachitic beads) which are visible and felt at the junction with sternum.
The affected children show symptoms of Harrison grove, a horizontal line seen at the margin of the thorax where the ribs are attached to diaphragm. The pulling of the sternum gives rise to pigeon-chest deformity.
Mild to predominant Scoliosis (curving from side to side) of spine is seen in affected children. The softening of the vertebrae leads to kyphosis (hunchback).
scoliosis
Scoliosis of spine
The weight bearing long bones in the legs get bent and bow-legs or knock-knees occur as signs of the disease in affected children. The bend may cause fracture on one side and this is called greenstick fracture.
In the rickets affected thickening of skull occurs producing frontal bossing and delaying the anterior fontanelle closure giving square forehead look; typical rickets signs.
Radiography shows symptoms like flaring and cupping of the metaphyses of the long bones in the affected children.
These affected persons lose their weight and show increase in vascularity. This hyperemia (increase in blood flow) affects all bones, cartilages, morrow, resulting in irregular and retarded growth of bones and cartilage cell proliferation.
In young affected children the teeth may erupt very late. They may have irregular shape and the enamel may be defective and caries and cavities may occur; another of typical rickets signs.
The rickets affected may show delay in crawling, sitting up and walking. In severe cases there may be respiratory failure in children.
Observing these signs, diagnosis of rickets can be done by visual observations, blood test, urine test and x-ray. If detected early all rickets symptoms can be resolved completely.

Related topics:
Rickets
Causes
Diagnosis
Treatment
Prevention
Osteomalacia (in adults)

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Scorbutus - Scurvy symptoms and signs

› › Scurvy Signs and symptoms

The typical scurvy symptoms and signs include general weakness, painful joints and muscles, hemorrhage of gums and mucous membranes, anemia, livid spots on the legs and corkscrew hair.
The signs and symptoms of scorbutus develop after 2-3 months of severe deficiency of vitamin C.
By this time much of the body stores of vitamin C are depleted and plasma concentrations may be nil.
This may be due to non inclusion of fresh fruits and vegetables in the diet.
Scurvy (scorbutus) may also arise due to dietary restrictions in illness, alcoholism or malabsorption.
The main symptoms of scorbutus (scurvy) are the reduced ability to produce and maintain collagen, which is very much required for the connective tissue fibres, bone matrix, cartilaginous tissues, dentin and the cementing substance of the vascular endothelium.
Lacking the cementing substance, the blood capillaries become permeable to red blood cells and hemorrhage occurs in the soft tissues of gums, mucous membrane and epidermis.
The scar tissue of the old wounds, which is made up of collagen, getting affected and the wounds opening up are indications of scurvy (scorbutus).
The lack of sufficient production of collagen causes bone formation to stop whereas the bone absorption goes on causing bone abnormalities, swollen joints, muscular and bone pains and loosened teeth.
In children there may be painful swelling in the legs followed by nausea, diarrhea and fever as scurvy (scorbutus) signs and symptoms.
The loss of blood due to hemorrhage, gastrointestinal bleeding and diffusion of blood into skin leads to anemia.
Lack of vitamin C may further alter the metabolism and absorption of iron and folic acid and increase the anemia and cause scurvy jaundice.
Scurvy symptoms and signs like bleeding of the conjunctiva in the eyes, dryness of eyes and blurring of vision may be encountered.
In scurvy, breathlessness, rapid heart rate and chest pain may be experienced and may lead to heart failure.
The manifestations of scurvy vary from person to person and many of the symptoms listed below may be experienced.
Scurvy disease pictures: cork screw hair condition brought about by vitamin C deficiency
Scurvy disease pictures - corkscrew hair condition (enlarge)

Signs and symptoms of scurvy

  • tiredness
  • malaise
  • exhaustion
  • fainting
  • lethargy
  • uneasy feeling
  • irritability
  • nausea
  • loss of appetite
  • weight loss
  • livid (black-blue) spots on the legs (typical of scurvy)
  • weak capillaries
  • bleeding into skin 
  • easy bruising on small abrasions
  • swollen and bleeding gums
  • bleeding mucous membrane
  • fingertip bleeding
  • loosening of teeth
  • dental cavities
  • bleeding spots around the hair follicles
  • corkscrew hair
  • thinning of hair
  • dry skin
  • dry and red eyes
  • bleeding in the eyes and eyelids
  • bulging eyes
  • gastrointestinal bleeding
  • delay in the healing of wounds
  • opening up of old wounds and bleeding
  • rectal bleeding
  • anemia
  • jaundice
  • painful muscles and bones
  • swollen joints
  • sore and swollen joints
  • lung and kidney problems
  • signs of neuropathy
  • convulsions
  • fever
  • bilateral swelling in the legs
  • general oedema
  • depression

Signs and symptoms of scurvy in children

  • painful swelling of legs
  • signs of irritability
  • anaemia
  • bleeding in the ends of long bones
  • vomiting
  • diarrhea
  • fever
  • impaired growth of bones
All these scurvy signs and symptoms can be reversed by taking food rich in vitamin C and by taking ascorbic acid supplements.

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Osteomalacia symptoms - Soft bones

Home > Osteomalacia signs and symptoms

Common signs and symptoms of osteomalacia are bone pain, muscle pain and easy fractures of bones in the adults.

Osteomalacia affected patient shows signs and symptoms like widespread pain in the bones

The signs of osteomalacia may not be confused with arthritis pain which is the inflammation of the joints and the resultant pain.
The signs and symptoms are specific. Osteomalacia caused pain emanates from the skeletal tissue. This pain is of permanent character deep and nagging.
The pain emanates from back, hips, ribs and long bones. Pain is also caused by minor cracks (partial fractures).

Osteomalacia affected person shows signs and symptoms of weak muscles

With the pain in the bones the patients mobility decreases and the patient may also show signs of myalgia (muscle pain).
Low levels of calcium and phosphorus along with low levels of vitamin D affect muscle functions.
With reduced activity the muscle mass may decrease and muscle atrophy may set in. There can be partial or complete wasting away of the muscles.
Muscle weakness especially of the upper arms and thighs, decreases the quality of life and the sufferer experiences great difficulty in performing simple tasks like getting up from a chair or climbing a flight of stairs.

Osteomalacia affected person shows symptoms like fractures on trivial causes

Pathologic fractures may occur in osteomalacia affected person. The fractures occur during the normal routine activities.
The reason for this is that the bones have so badly demineralised that they are not able to perform normal routine functions.

Deformity in osteomalacia

The affected person may suffer from lordosis a deformed condition of the vertebrae.
There is curvature of the vertebral column in lower back giving 'swayback' appearance to the person. Deformities of the pelvis may also occur.
The gait of the patient is affected and he shows typical signs of waddling gait (myopathic gait).
The waddling is due to deformity of the pelvic girdle and also due to proximal muscles getting weak.
The osteomalacia patient sometimes may experience tetany. Uncontrolled muscle spasm and seizures are due to low serum levels of calcium.

Related topics:
Osteomalacia.
Causes.
Diagnosis.
Treatment.
Prevention.
Rickets in children.

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Pellagra disease - Symptoms - Signs

› › Pellagra disease - Symptoms and signs

Pellagra disease caused signs and symptoms manifest on skin, gastrointestinal system, mucous membranes, muscular and skeletal system, nervous system and vascular and renal system.

Early symptoms of Pellagra

Early signs and symptoms of pellagra manifest as loss of weight, weakness, fatigue, muscular and joint pains, backache, lassitude, headache, anxiety, irritability, depression, loss of appetite, indigestion, constipation, and skin lesions and rashes without any obvious causes.

Symptoms of pellagra disease on skin

Initial symptoms manifests as skin inflammations, lesions and rash with itching and burning sensation. Photodermatitis is one of the typical signs of the disease. The areas of skin exposed to sunlight become red and inflamed and show symptoms of sunburn. Later even heat and friction causes inflammation and dermatitis. The skin becomes dry and scaly. Further the edge between the rash and the unaffected skin is clearly demarcated.

The pellagra caused erythema may occur anywhere on the body where it is exposed to sunlight, friction or heat. The common regions of dermatitis are hands, arms, face, exposed neck, feet and lower legs. On the face of the affected patient, the sun exposed forehead, cheeks and nose get inflamed. The lips may also get inflamed and bleed; typical symptoms.

Depending upon the type of dress and exposure, the neck gets affected by the disease. The lesions on the exposed back of the hands of the patient appear like gloves. The exposed legs and feet are affected up to the edge of the pants or skirts by pellagra. The pressure points and genitals also may be affected by dermatitis.

In the later stages of pellagra, the skin becomes thick, scaly, hard and cracked. The skin becomes brown and dark with scaly dermatitis, bleeding at the blackened crusts and sloughing off at places. These areas of skin get easily infected and weeping sores appear. Further in this disease alopecia (loss of hair) are caused by pellagra. Angular stomatitis and Cheilosis are sometimes encountered as symptoms of niacin deficiency. swollen tongue and dermatitis on hands are symptoms and signs of pellagra
Photo dermatitis on hands and swollen tongue are symptoms and sign of pellagra disease (enlarge)

Symptoms and signs of disease on mucous membranes

The typical symptoms of pellagra on mucous membranes like mouth, tongue, nasal passage and in some cases vagina are that they become sore, red, thick, inflamed and swollen. Acute pain and burning sensation is experienced.

Signs of pellagra disease on the gastrointestinal system

Initially pellagra causes on the gastrointestinal system are excessive salivation, anorexia (lack of appetite), dyspepsia (indigestion), burning sensation in the throat, constipation and diarrhea. With the development of extremely painful sores and swelling in the mouth and the tongue the affected person will not able eat food properly leading to further .

Later signs like abdominal pain, abdominal bloating, nausea, vomiting and diarrhea with intestinal bleeding may follow if the deficiency of vitamin B3 (niacin) is not corrected. Gastritis and bloody diarrhea lead to infections and the patient may get dehydrated and become anaemic.

Signs of pellagra on the nervous system

The initial effect of pellagra disease on the central nervous system are insomnia (sleeplessness), anxiety, depression and apathy (indifference). The next stage of signs of pellagra are aggressive behaviour, headache, forgetfulness, progressive memory loss, confusion, disorientation, delusions, neuritis (inflammation of the nerves, paranoia (mental derangement) psychosis, and hallucinations (illusion of seeing and hearing things which are not present). The final stage signs of pellagra disease are delirium, dementia, tremor, stupor and coma.

Signs of pellagra on skeleto-muscular systems

In severe condition of pellagra disease symptoms like stiffness and inability to move arms and legs sets in. The patients also show signs like involuntary grasping and sucking movements , ataxia (lacking control over muscular movements) and fluid retention.

Pellagra disease, if not treated with therapeutic doses of vitamin B3 can become fatal. If not treated early, the signs and symptoms pellagra may not totally disappear.
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Signs and symptoms of pellagra disease.
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