Yokota T, Tsuchiya K, Furukawa T, Tsukagoshi H, Miyakawa H, Hasumura Y
Department of Neurology, Medical and Dental University, Tokyo, Japan.
J Neurol. 1990 Apr;237(2):103-6. doi: 10.1007/BF00314671.
Thirteen patients with adult-onset vitamin E deficiency due to fat malabsorption were investigated clinically and electrophysiologically. These patients had slightly or moderately decreased serum vitamin E (1.7-4.8 micrograms/ml, normal less than 6.0) or vitamin E/cholesterol ratio (0.21-0.31 mg/g, normal less than 0.35). Only one patient had typical neurological manifestations of vitamin E deficiency, which improved with supplementary vitamin E. The pathological findings in this patient were also compatible with vitamin E deficiency. This patient had poorly controlled diabetes mellitus due to advanced chronic pancreatitis. Reviewing previously reported cases of vitamin E deficiency with diabetes mellitus in chronic pancreatitis, the duration of deficiency until the onset of symptoms was shorter than in those cases without complications. Although adult patients with early, slight deficiency of vitamin E are generally asymptomatic, patients with diabetes mellitus tend to have early neurological symptoms. The vitamin E tolerance test should be used, because even in some patients with vitamin E deficiency due to malabsorption, the deficiency can be overcome by large oral doses of vitamin E.
对13例因脂肪吸收不良导致成人维生素E缺乏的患者进行了临床和电生理研究。这些患者血清维生素E（1.7 - 4.8微克/毫升，正常低于6.0）或维生素E/胆固醇比值（0.21 - 0.31毫克/克，正常低于0.35）轻度或中度降低。只有1例患者有典型的维生素E缺乏神经表现，补充维生素E后症状改善。该患者的病理结果也与维生素E缺乏相符。该患者因晚期慢性胰腺炎导致糖尿病控制不佳。回顾先前报道的慢性胰腺炎合并糖尿病的维生素E缺乏病例，症状出现前的缺乏持续时间比无并发症的病例短。尽管成年早期轻度维生素E缺乏患者通常无症状，但糖尿病患者往往会较早出现神经症状。应进行维生素E耐量试验，因为即使在一些因吸收不良导致维生素E缺乏的患者中，大剂量口服维生素E也可克服这种缺乏。
