A 41-year-old man on isoniazid and rifampin for pulmonary tuberculosis presents with irritability, progressive numbness in his hands, and new-onset generalized seizures. Vital signs: BP 128/82 mmHg, HR 92/min, RR 16/min, Temp 37.2°C. Peripheral blood smear reveals microcytic anemia with ring sideroblasts. Serum glucose is normal. He denies alcohol use. Which vitamin deficiency best explains his neurologic and hematologic findings?
- A)Folate
- B)Biotin
- C)Ascorbic acid
- D)Niacin
- E)Pyridoxal phosphateGABARITO
Explicação
Isoniazid can cause vitamin B6 deficiency, leading to decreased pyridoxal phosphate. Pyridoxal phosphate is required for transamination reactions, delta aminolevulinate synthase in heme synthesis, and glutamate decarboxylase for GABA synthesis, explaining side... Ver explicação completa e trilha adaptativa →