RESUMO
A brief history of what is now known as the Van der Hoeves syndrome is described. The case reports of two members of a family with blue scleras and deafness, and who in the past suffered from some form of dislocation or fractures, are presented. The first case came because of impairment of hearing. The second case developed unilateral deafness, which was discovered only when subjected to the various functional tests for hearing. Only after some questioning did he admit that his hearing in the right ear was not what it used to be. In both cases the deafness was of the conductive type and fulfilled the criteria of clinical otosclerosis as described in textbooks. The disease was from the paternal side, but that was as far as the hereditary history could be traceAs mentioned earlier, the incidence of clinical otosclerosis is infrequent among the Filipinos; but the actual rate of incidence has not been studied. In studies abroad, the Negroes are also less affected than the whites. The reason for this difference is not known. D.W. Brickley Jr. believes that a possible clue to the causation of otosclerosis may be found through studies of this interesting and unique syndrome. (Summary and Comment)
Assuntos
EscleraRESUMO
We have reported here an outbreak of nutritional eye disease associated with multiple vitamin deficiencies. This seems to be the first epidemic of this nature ever reported in this country. The chief complaint was dimness of vision in both eyes, the cause of which was: (1) chronic retrobulbar neuritis or (2) superficial vascularizing keratitis or (3) both affections co-existing. The patients invariably gave the history of having subsisted for some time on very deficient diet-deficient both in quantity and in quality. They were on the whole healthy up to the time of onset of their complaint. Adult males and females were attacked. In females, pregnancy and lactation were predisposing factorsIn many patients associated signs and symptoms of vitamin B complex deficiency were observed-namely, angular stomatitis, glossitis, numbness around the mouth, hyperesthesia or hyposthesia in the extremities, and other manifestationsThe retrobulbar neuritis was probably brought about by several known and unknown causes but mainly by the deficiency of the B1 factor and especially of the vitamin B complex: Likewise, the superficial vascularizing keratitis was brought about by similar mechanism-the deficiency of the B2 factor of the same vitamin B complex playing a predominant roleThe essence of the treatment was the administration of well-balanced and liberal diet, especially rich in vitamins that were suspected to be insufficient. Prompt response was noted. In those cases in which a let up in the liberal dietary regime could not be helped owing to economic reasons, relapse occurredThe outbreak of the epidemic commenced soon after the war, reaching the maximum height of incidence about December 1942 and practically disappeared about the end of September 1943. The cause could be traced to the sudden dislocation in the supply of foods and the poor economic conditions of the masses occasioned by the national emergency. Unfortunately, no laboratory tests were employed for the estimation of the different vitamin content of the blood or urine to check the clinical diagnosis by dietary trial. Since satisfactory results appeared promptly after dietary therapy alone, the presumption of a deficiency disease was considered verifiedWe conclude this report by emphasizing that there is a great neccessity for continuing the study of nutritional eye diseases in collaboration with the internist, the neurologist, the nutritionist, and the pathologist. There is likewise an imperative need of recommending to the public a balanced diet that is both easily available and within the reach of even the poorest in order to help forestall future outbreaks of serious epidemics of deficiency diseases in the face of sudden and unexpected national emergencies that may disrupt the adequate supply of foods for the masses. (Summary)