Carotenemia

Introduction Caroteneemia is a yellow-stained skin caused by high levels of carotene in the blood. Carotene is a lipid pigment that gives normal skin a yellow color. If you eat too much carotene-rich carrots, oranges, pumpkins, red palm oil, etc., the blood carotene content will be significantly increased. Hyperlipidemia, hypothyroidism, diabetes, or other congenital defects or liver diseases that convert carotene into vitamin A, can also cause the sole sign of caroteneemia in the blood to be yellow or orange-yellow, unconscious Symptoms, but the sclera is not yellow. The disease occurs mostly in the palms and athlete's foot. Sometimes face, mouth and eyelids can also appear. In severe cases, the skin of the whole body is orange-yellow, and the content of carotene in plasma exceeds 250 g%.

Cause

Caused by high levels of carotene in the blood. After carotene is absorbed, part of it is cleaved into vitamin A in the intestinal mucosa. The untransformed person directly enters the bloodstream, and some of them are transformed in the liver or other tissues. Fat and bile salts are necessary conditions for carotenoid absorption by the intestine. Bile salts can emulsify fat, strengthen the activity of carotenoid lyase, and promote the conversion of carotene into vitamin A, which is beneficial to its absorption, operation and metabolism. Excessive intake of foods and fruits rich in carotene, such as carrots and oranges, long-term treatment of certain diseases (such as porphyria and light-sensitive diseases) with diabetes, increased blood lipids, nephritis, hypothyroidism, hepatitis, and Other congenital metabolic disorders that have been converted to vitamin A by carotenoids affect carotene conversion and increase in carotenoid content after men have been exposed to sputum.

an examination

The amount of carotene in the patient's plasma exceeds normal, and excess carotene is excreted in the urine. Take aliquots of serum, ethanol, petroleum ether, after mixing and shaking, see the lipoprotein dissolved in petroleum ether, this method can help diagnose. The diagnosis of this disease is mainly based on medical history, symptoms and laboratory tests. Should be differentiated from the jaundice of hepatobiliary diseases, the latter sclera yellow staining, elevated blood bilirubin, take a pingping caused by skin yellowing has a history of medication.

Differential diagnosis

Endotoxemia: A pathophysiological manifestation caused by bacteria in the blood or bacteria in the lesion releasing a large amount of endotoxin to the blood, or by injecting a large amount of liquid contaminated by endotoxin. Endotoxemia is divided into two categories: endogenous and exogenous. Clinical manifestations of chills, chills, hyperthermia, white blood cells and neutrophils increased. There is no restriction on a system that tends to or find multiple systems with migratory inflammation and multiple organ dysfunction. There is often a history of infection before the disease. In particular, those who have a basic disease that seriously affects the body's defense function, and who cannot control fever and other signs of systemic infection with general antibacterial drugs, should consider the possibility of endotoxemia. If there are defects or ecchymoses in the skin and mucous membranes, or complicated with septic shock, the clinical diagnosis of endotoxemia is basically established.

Toxemia: refers to the bacterial toxin from the local infection of the lesion into the blood circulation, resulting in systemic sustained high fever, accompanied by a lot of sweating, pulse weak or shock.

Nitrogenemia: It is a biochemical term. The general concept is that as long as the blood urea nitrogen, non-protein nitrogen or creatinine exceeds the normal range, it can be called azotemia. Various kidney diseases are prolonged and unhealed, and renal function damage may occur in the late stage, so that nitrogen leakage in the blood is blocked, and sputum accumulates in the blood, which is the result of renal failure. However, normal people eat high-protein foods in a short period of time, such as Chinese New Year holidays or too many banquets. Although the kidney function is normal, but the excessive nitrogen can not be quickly discharged in a short time, it will appear once. Sexual azotemia. In addition, patients with nephrotic syndrome edema and oliguria may also have transient azotemia. When diuretics are applied, the amount of urine increases, and blood urea nitrogen will also fall to normal. This cannot be regarded as renal failure. There is no need for patients to carry heavy burdens of thought.

Hyperandrogenemia: follicular phase of normal menstrual cycle, serum testosterone concentration is 0.43ng/ml on average, high limit is 0.68ng/ml, such as over 0.7ng/ml (=2.44nmol/L), ie hyperandrogenism, Also known as high testosteroneemia. It is a common gynecological endocrine disease. According to clinical manifestations, especially menstrual thinning, amenorrhea or dysfunctional uterine bleeding, plus some masculinity characteristics should consider the possibility of this disease. The diagnosis is based on an increase in blood testosterone >0.7 ng/ml or >2.44 nmol/L. Others, such as B-ultrasound, clomiphene test and other auxiliary examinations can assist in diagnosis.

Galactosemia: a toxic clinical metabolic syndrome with increased blood galactose. There are three related enzymes in galactose metabolism: congenital defects can cause galactosemia: 1 galactose-1-phosphate uridine acyltransferase (Gal-1-PUT) defect: this is a classic Galactosemia is more common. 2 galactose kinase deficiency: relatively rare. 3 urinary-glycophosphate galactose-4-epimerase (UDP-Gal-4-E) deficiency: rare. Most children have lactation, vomiting, nausea, diarrhea, weight loss, hepatomegaly, jaundice, bloating, hypoglycemia, proteinuria, etc., due to galactose in breastfeeding or artificial feeding. The performer should consider the possibility of galactosemia, and the relevant laboratory tests should be carried out. If the measures can be detected and taken in time, cataracts and mental retardation can occur rapidly. The amount of carotene in the patient's plasma exceeds normal, and excess carotene is excreted in the urine. Take aliquots of serum, ethanol, petroleum ether, after mixing and shaking, see the lipoprotein dissolved in petroleum ether, this method can help diagnose. The diagnosis of this disease is mainly based on medical history, symptoms and laboratory tests. Should be differentiated from the jaundice of hepatobiliary diseases, the latter sclera yellow staining, elevated blood bilirubin, take a pingping caused by skin yellowing has a history of medication.

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