VII. EFFKCTS OF DKFICIENCY 557 



iiKMit, some (tt which may he (Icrixcd lioin red Mood cells,-"'-' is coiiiinoiily 

 associated with alhcroinatous lesions of the aoila and olhcr xcssels,-""' -'" 

 and that athcronialous aortas are said to contain peroxides-'" such as arc 

 associatetl with sites of ceroid toiniation in vitamin lO-delicient animals. 

 A ceroid-like pigment in the human o\aiy lias also been described by 

 Bremier'-'- and by lleaf>;an,'-'' usually in association with lollicular atresia, 

 and rei>;arded as an oxidation pioduct ol' vitamin A (or carotene) and un- 

 saturated fats, catalyzed perhaps by lipoxidase of the ovarian tissues. 



It should bo made clear that in the studies describinj;- ceioid in human 

 tissues no claim is matle that an avitaminosis K is involved. Ceroid may 

 arise in tissues where, in association with un.saturated fats, there are local 

 oxidative disturbances similar to those occurrinji; in vitamin E deficiency 

 but due to other causes; there is also the possibility of a localized destruc- 

 tion of intracellular tocopherol due to metabolic stress or chemical insult 

 even though the tocopherol status of the body in general is normal. 



There are several reports which present more definite suggestions that 

 human beings may approach a state of conditioned avitaminosis E. Pappen- 

 heimer and Mctor-"^ have presented in considerable detail the postmortem 

 findings on four individuals exhibiting chronic nutritional disorders (idio- 

 pathic hypoproteinemia, gastrocolic fistula subsecjuent to gastroenteros- 

 tomy, non-tropical sprue, and chi'onic jejunitis with cirrhosis) in which 

 there w^as found an abundance of acid-fast pigment having much the same 

 localization as that seen in vitamin E-deficient animals. In all cases, there 

 was pronounced pigmentation of the muscular coats of the esophagus, 

 stomach, and small intestine, such as seen in the E-deficient monkey and 

 in dogs with biliary fistulae. Acid-fast pigment was also noted in liver cells, 

 Kupffer cells, uterine muscle, phagocytes of ovarian stroma, cardiac and 

 skeletal muscle, media of small arteries, and the Sertoli syncytium and 

 interstitial cells of the degenerate testes of the one male of the series. 

 Tverdy et al.-^* present a detailed clinical history and postmortem findings 

 in a case of non-tropical sprue, in which they noted acid-fast pigment with 

 essentially the same distribution in intestinal smooth muscle, liver, degen- 

 erate testes, and macrophages of various organs and tissues. Histopatho- 

 logic changes were also noted-"^ in the central nervous system, including 



2«9 W. S. Hartroft, Am. J. Pathol. 28, 526 (1952). 



"« R. C. Burt, Am. J. Clin. Pathol. 22, 1.35 (1952). 



2" J. Glavind, S. Hartmann, .J. Clemme.sen, K. E. Jes.scn, and H. Dam, Acta Pathol. 



30, 1 (1952). 

 2'2 S. Brenner, S. African J. Med. Sci. 11, 173 (1946). 

 2'3 J. W. Reagan, Am. J. Obsiet. Gynecol. 59, 483 (1950). 

 2'4 G. Tverdy, A. L. Froehlicli, and B. Fieren.s, Acta Gastro-enterol. Bclf/. 12, 221 



(1949). 

 2>^« L. van Bogaert and G. Tverdy, Monat.s.'^chr. Psijchiat. Nenml. 120, 301 (1950). 



