558 THE TOCOPHEROLS 



the presence of much acid-fast pigment, especially in relation to blood 

 vessels and the choroid plexus epithelium. They consider these changes to 

 be strongly indicative of an avitaminosis E associated with sprue. 



Reference has been made (p. 544) to the low serum tocopherol levels and 

 flat type of absorption curve observed in sprue, celiac disease, and similar dis- 

 orders. ^^^ Also of interest is the comment of Frazer^^^ that "Dietary inade- 

 quacy is certainly not a common cause of vitamin deficiency in the sprue 

 syndrome. It may account for the occasional case of vitamin E deficiency, 

 especially since oxidative rancidity of fats may be one of the precipitating 

 causes in tropical sprue." 



It is unfortunate that in the five cases referred to above no data could 

 be obtained on serum tocopherol levels prior to death or on tissue levels 

 at postmortem. With lack of evidence of this type, the findings reported 

 can be considered only highly indicative that a conditioned state of avita- 

 minosis E may sometimes occur in man as a result of chronic diseases 

 which seriously interfere with the absorption of fats and fat-soluble vita- 

 mins. 



(2) Progressive Muscular Dystrophy. Many investigators have been im- 

 pressed by the striking similarity between the skeletal muscle lesions of 

 progressive muscular dystrophy and dermatomyositis in man, and those of 

 nutritional myodegeneration which represent the most characteristic 

 manifestation of vitamin E deficiency in experimental animals (p. 552). 

 This applies also to myocardial lesions, which constitute a rather charac- 

 teristic finding in progressive muscular dystrophy^^^- ^" as they do in many 

 animal species deficient in vitamin E. 



There is also evidence of a common biochemical defect, in the form of 

 urinary excretion of ribose-phosphorus-containing complexes which appear 

 to be rather specific for human muscular dystrophy"^ ^^^ • ^^^^ and which occur 

 also in dystrophic vitamin E-deficient rabbits. ^^^ The suggestion that these 

 complexes may reflect disturbances in nucleotide metabolism is in keeping 

 with other evidence of disturbed nucleic acid metabolism in the vitamin 

 E-deficient rabbit^^" and monkey .^-^ Of particular interest is the observa- 

 tion of Minot et al}^^ that "pentose-containing complexes were detected in 

 the urine of an apparently normal 3 year old brother of one of our patients 



216 A. C. Frazer, Brit. Med. J. II, 731 (1949). 



216 W. G. Nothacker and M. G. Netsky, Arch. Pathol. 50, 578 (1950). 



2" J. Zatuchni, E. E. Aegerter, L. Molthan, and C. R. Shuman, Circulation 3, 846 



(1951). 

 2'8 A. S. Minot, H. Frank, and D. Dziewiatkowski, Arch. Biochem. 20, 394 (1949). 

 218a W. F. Orr and A. S. Minot, Arch. Neurol. Psi/chiat. 67, 483 (1952). 



219 A. S. Minot and M. Grimes, /. Nutrition 39, 159 (1949). 



220 J. M. Young and J. S. Dinning, ./. Biol. Chcm. 193, 743 (1951). 



221 J. S. Dinning, L. D. Seager, and P. L. Day, Federation Proc. 10, 380 (1951). 



