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The American Journal of Case Reports Mar 2019BACKGROUND Beriberi due to thiamine (vitamin B1) deficiency has two clinical presentations. Patients with dry beriberi present with neuropathy, and patients with wet...
Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature.
BACKGROUND Beriberi due to thiamine (vitamin B1) deficiency has two clinical presentations. Patients with dry beriberi present with neuropathy, and patients with wet beriberi present with heart failure, with or without neuropathy. Dry beriberi can mimic the most common form of Guillain-Barre syndrome (GBS), an acute inflammatory demyelinating polyradiculoneuropathy (AIDP). Severe thiamine deficiency results in Wernicke's encephalopathy. This report of a case of dry beriberi and Wernicke's encephalopathy due to thiamine deficiency includes a review of the literature. CASE REPORT A 56-year old woman with a history of gallstone pancreatitis and protein-calorie malnutrition was treated six months previously with total parenteral nutrition (TPN). She initially presented at another hospital with paresthesia of the lower limbs, arms, and neck, and symptoms of encephalopathy. Initial diagnosis of GBS was made, based on magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) findings. Despite five days of intravenous immunoglobulin (IVIG) treatment, her encephalopathy worsened, requiring transfer to our hospital, where she required intubation and treatment with vasopressors. A repeat MRI of her brain showed changes consistent with Wernicke's encephalopathy. Following treatment with high-dose intravenous thiamine, her mental status improved within 48 hours, and by the third hospital day, she no longer required intubation. CONCLUSIONS Symptoms and signs of dry beriberi due to thiamine deficiency can mimic those of acute or chronic GBS. However, thiamine repletion leads to rapid clinical improvement and can prevent irreversible neurologic sequelae, including Korsakoff syndrome. Clinicians should consider thiamine deficiency in malnourished patients presenting with symptoms and signs of GBS.
Topics: Beriberi; Diagnosis, Differential; Female; Guillain-Barre Syndrome; Humans; Middle Aged; Peripheral Nervous System Diseases; Thiamine Deficiency; Wernicke Encephalopathy
PubMed: 30862772
DOI: 10.12659/AJCR.914051 -
Monograph Series. World Health... 1976
Review
Topics: Adult; Age Factors; Beriberi; Cardiovascular Diseases; Edema; Female; Food, Fortified; Humans; Hydrolases; Infant; Japan; Lactation; Male; Military Medicine; Nervous System Diseases; Oryza; Pregnancy; Thiamine
PubMed: 824828
DOI: No ID Found -
Tidsskrift For Den Norske Laegeforening... Apr 2021
Topics: Beriberi; Heart Failure; Humans; Thiamine
PubMed: 33876616
DOI: 10.4045/tidsskr.21.0215 -
Nutrition Reviews Dec 2020Beriberi is a nutritional complication of gastric surgery, caused by deficiency of vitamin B1, or thiamine. Thiamine deficiency leads to impaired glucose metabolism,... (Review)
Review
Beriberi is a nutritional complication of gastric surgery, caused by deficiency of vitamin B1, or thiamine. Thiamine deficiency leads to impaired glucose metabolism, decreased delivery of oxygen by red blood cells, cardiac dysfunction, failure of neurotransmission, and neuronal death. This review describes the history and pathophysiology of beriberi as well as the relationship between beriberi and nutritional deficiencies after gastric surgery. A literature review of the history and pathophysiology of beriberi and the risk factors for thiamine deficiency, particularly after gastric resection or bariatric surgery, was performed. Recommendations for nutritional follow-up post gastric surgery are based on current national guidelines. Patients may have subclinical thiamine deficiency after upper gastrointestinal surgery, and thus beriberi may be precipitated by acute illness such as sepsis or poor dietary intake. This may occur very soon or many years after gastrectomy or bariatric surgery, even in apparently well-nourished patients. Prompt recognition and administration of supplemental thiamine can decrease morbidity and mortality in patients with beriberi. Dietary education post surgery and long-term follow-up to determine nutritional status, including vitamin and mineral assessment, is recommended for patients who undergo gastric surgery.
Topics: Bariatric Surgery; Beriberi; Dietary Supplements; Digestive System Surgical Procedures; Gastrectomy; Humans; Malnutrition; Nutritional Status; Stomach; Thiamine; Thiamine Deficiency; Vitamin B Complex
PubMed: 32388553
DOI: 10.1093/nutrit/nuaa004 -
Annals of the New York Academy of... Aug 2021Thiamine is an essential water-soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due... (Review)
Review
Thiamine is an essential water-soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due to the broad clinical spectrum, referred to as thiamine deficiency disorders (TDDs), affecting the metabolic, neurologic, cardiovascular, respiratory, gastrointestinal, and musculoskeletal systems. Concurrent illnesses and overlapping signs and symptoms with other disorders can further complicate this. As such, TDDs are frequently misdiagnosed and treatment opportunities missed, with fatal consequences or permanent neurologic sequelae. In the absence of specific diagnostic tests, a low threshold of clinical suspicion and early therapeutic thiamine is currently the best approach. Even in severe cases, rapid clinical improvement can occur within hours or days, with neurological involvement possibly requiring higher doses and a longer recovery time. Active research aims to help better identify patients with thiamine-responsive disorders and future research is needed to determine effective dosing regimens for the various clinical presentations of TDDs. Understanding the clinical diagnosis and global burden of thiamine deficiency will help to implement national surveillance and population-level prevention programs, with education to sensitize clinicians to TDDs. With concerted effort, the morbidity and mortality related to thiamine deficiency can be reduced.
Topics: Age Factors; Beriberi; Combined Modality Therapy; Diagnosis, Differential; Disease Management; Disease Transmission, Infectious; Humans; Organ Specificity; Population Surveillance; Symptom Assessment; Thiamine; Thiamine Deficiency
PubMed: 33305487
DOI: 10.1111/nyas.14536 -
Internal Medicine Journal Dec 2021
Topics: Beriberi; Humans; Scurvy; Thiamine
PubMed: 34939283
DOI: 10.1111/imj.15616 -
Food and Nutrition Bulletin Sep 2021Beriberi is the clinical manifestation of thiamine deficiency. It is multicausal and typically associated with poverty and food insecurity among vulnerable populations,...
BACKGROUND
Beriberi is the clinical manifestation of thiamine deficiency. It is multicausal and typically associated with poverty and food insecurity among vulnerable populations, such as indigenous people.
OBJECTIVE
The objective of this study was to carry out a spatial analysis of reported cases of beriberi among indigenous people in Brazil.
METHODS
Cross-sectional study using time series data on suspected cases of beriberi reported to the Ministry of Health via the FormSUS between July 2013 and September 2018. Indigenous villages were georeferenced, and Kernel density estimation was used to identify patterns of the spatial distribution of beriberi cases.
RESULTS
A total of 414 cases of beriberi were reported in the country of which 210 (50.7%) were indigenous people. All the cases in indigenous people occurred in states located in the Legal Amazon (Maranhão, Roraima, and Tocantins). Kernel density estimation showed high-density areas in Tocantins and Roraima.
CONCLUSIONS
This is the first nationwide study of reported cases of beriberi. The findings can be used to guide actions that contribute to the monitoring and prevention of beriberi among indigenous people.
Topics: Beriberi; Brazil; Cross-Sectional Studies; Humans; Indigenous Peoples; Poverty; Thiamine
PubMed: 34060356
DOI: 10.1177/03795721211002057 -
Obesity Facts 2014The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical... (Review)
Review
BACKGROUND
The epidemic growth of morbid obesity has led to an increase in the number of bariatric interventions. During the distribution process of bariatric surgical interventions, the risk for severe nutritious complications such as bariatric beriberi can rise.
METHODS
By means of systematic literature review, epidemiological data, clinical characteristics and diagnostic as well as therapeutic recommendations for bariatric beriberi were elicited. Databases and registries such as PubMed, Cochrane and Ovid were searched for a defined time period with the key words 'lack of thiamine' / 'Wernicke-Korsakoff syndrome' / 'encephalopathy' after bariatric surgical interventions.
RESULTS
Up to December 2013, overall 255 patients had been found as published cases, indicating that the risk for the postoperative occurrence of thiamine deficiency and Wernicke-Korsakoff syndrome is increased in women. In addition, the risk correlates with patient's age. The majority of patients developed symptoms of a dry beriberi with peripheral neuritis, ataxia and paraplegia, indicating an advanced stage of disease approximately 4-12 weeks postoperatively. Laboratory analysis in case of a suspicious clinical finding is the appropriate diagnostics. As treatment, prompt initiation of parenteral thiamine substitution under clinical monitoring is required.
CONCLUSION
Bariatric beriberi can occur within the first 1-3 postoperative months. To minimize the risk of severe consequences, immediate substitution of thiamine in clinical suspicion or prolonged parenteral nutrition is necessary. A delayed diagnosis or missing the correct diagnosis can lead to irreversible damages of the CNS with coma and fatal outcome. Knowledge on the subject, including development of thiamine deficiency, symptomatology and emergency treatment, are considered essential for bariatric surgeons but also for further medical disciplines involved in treatment.
Topics: Bariatric Surgery; Beriberi; Humans; Korsakoff Syndrome; Obesity, Morbid; Postoperative Complications; Thiamine
PubMed: 25095897
DOI: 10.1159/000366012 -
Eating and Weight Disorders : EWD Mar 2021Nowadays, reports of beriberi are rare in developed countries. Wernicke encephalopathy may be present in about 25% of patients with beriberi. (Review)
Review
INTRODUCTION
Nowadays, reports of beriberi are rare in developed countries. Wernicke encephalopathy may be present in about 25% of patients with beriberi.
CASE REPORT
We report the case of a woman with history of depression and chronic eating disorder, who complained Wernicke encephalopathy and beriberi. Sural nerve and muscular biopsy were performed, showing severe axonal neuropathy. Thiamine supplementation was started with rapid improvement of the pulmonary and cardiac affections; improvement of peripheral neuropathy was incomplete.
CONCLUSIONS
Thiamine deficiency can be misdiagnosed. Beriberi is an important cause of acute flaccid paralysis; hence, clinicians should consider this diagnosis and prompt start thiamine treatment to avoid permanent neurological sequelae.
Topics: Beriberi; Feeding and Eating Disorders; Female; Humans; Thiamine; Thiamine Deficiency; Wernicke Encephalopathy
PubMed: 32130681
DOI: 10.1007/s40519-020-00880-0 -
Revue Medicale de Liege 2007We discuss the case of a 49 year old man who was admitted to the emergency department with acute heart failure. He suffered from severe alcoholism and malnutrition. His...
We discuss the case of a 49 year old man who was admitted to the emergency department with acute heart failure. He suffered from severe alcoholism and malnutrition. His heart failure was of the high output type and the diagnosis beriberi, a disease caused by thiamine (vitamin B1) deficiency. The treatment consisted of intravenous administration of thiamine. The clinical response was spectacular with normalization of cardiac function within a few hours.
Topics: Acute Disease; Beriberi; Heart Failure; Humans; Male; Middle Aged; Thiamine; Vitamin B Complex
PubMed: 17853677
DOI: No ID Found