A 37 year-old woman complaining chiefly of a persistent burning sensation in the lower extremities (burning feet) and girdle pains in the lower thoracic and upperabdominal regions had long been diagnosed wrongly as having beri-beri, neurosis or even psycholsis by other physicians in various hospitals, before she visited our hospital in fall, 1959.
Despite her severe distress which was sometimes unbearable, however, a routine examination by means of inspection, palpation, percussion etc. disclosed no marked objective abnormality except indication of undernutrition, but a precise analysis of her -complaints, various clinical examinations and investigation concerning the effect of various treatments confirmed that she undoubtedly had pantothenic acid deficiency.
The etiology of the disease in this case seemed to be related with the extreme undernutrition which must have been caused by taking low-protein diet for many years being ordered erroneously by a physician as a therapeutic measure for essential hypertension which she suffered from. Although she used to take a considerable amount of multivitamin preparations, most of those preparations then sold in this country unfortunately contained only 0.5mg. per g. of pantothenic acid, so that the total amount of pantothenic acid that she absorbed from both food and vitamin preparations must have been much deficient.
The symptoms in this case became intensified by a tentative administration of various vitamins excluding pantothenic acid, while they were to a great extent improved soon after injection of a large amount of pantothenic acid, together with marked improvement in her spirits, appetite, body weight etc. On the other hand, however, oral administration of pantothenic acid showed no marked effect. A disturbed metabolism of protein was indicated in this case by measuring its content as well as its fractions in the serum, while no sign indicative of deficiency in other vitamins was observed. During our observation of the patient for 28 months, the onset of slight recurrence encountered only twice.
Based on the above-mentioning, the symptoms seen in this case was believed to becharacteristic of pantothenic acid deficiency. It was asserted that this paper was present ing the first clinical report on a case with pantothenic acid deficiency in this country.
