Commentary: Thiamine Deficiency in Tropical Pediatrics: New Insights into a Neglected but Vital Metabolic Challenge

Leite, Heitor Pons; Lima, Lúcio Flávio Peixoto de; Konstantyner, Túlio

doi:10.3389/fnut.2016.00058

Cited by 2 publications

(3 citation statements)

References 25 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combination of limited body storage and a high turnover rate (half-life <10 days) could result in potential depletion of thiamine stores within 2 weeks if it is not continuously replaced (3). This can be particularly troublesome for malnourished and critically ill patients (4), similar to our case. Thiamine deficiency has been shown to be present in patients upon intensive care unit (ICU) admission and can develop over time in ICU patients (10).…”

Section: Discussionsupporting

confidence: 82%

“…No tolerable upper intake level has been set for thiamine. In severe deficiency states, oral and intravenous administrations of doses far above the daily recommended intake for healthy people are considered safe (4).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the fact that it could be easily treated, TD continues to occur all age groups in both high and low resource countries with potentially severe and life-threatening consequences, including cardiovascular “shoshin” beriberi (3). Since children with malnutrition may have low or borderline thiamine reserves, they are prone to developing TD during refeeding without thiamine supplementation (4).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Shoshin Beriberi and Severe Accidental Hypothermia as Causes of Heart Failure in a 6-Year-Old Child: A Case Report and Brief Review of Literature

et al. 2019

View full text Add to dashboard Cite

Severe accidental hypothermia has been demonstrated to affect ventricular systolic and diastolic functions, and rewarming might be responsible of cardiovascular collapse. Until now, there have been only a few reports on severe accidental hypothermia, none of which involved children. Herein, we describe here a rare case of heart failure in a 6-year-old boy admitted to the emergency unit owing to severe hypothermia and malnutrition. After he was warmed up (core temperature of 27.2°C at admission), he developed cardiac arrest, requiring vasoactive amines administration, and veno-arterial extracorporeal membrane oxygenation. Malnutrition and refeeding syndrome might have caused the thiamine deficiency, commonly known as beriberi, which contributed to heart failure as well. He showed remarkable improvement in heart failure symptoms after thiamine supplementation. High-dose supplementation per os (500 mg/day) after reconstitution of an adequate electrolyte balance enabled the patient to recover completely within 2 weeks, even if a mild diastolic cardiac dysfunction persisted longer. In conclusion, we describe an original pediatric case of heart failure due to overlap of severe accidental hypothermia with rewarming, malnutrition, and refeeding syndrome with thiamine deficiency, which are rare independent causes of cardiac dysfunction. The possibility of beriberi as a cause of heart failure and adequate thiamine supplementation should be considered in all high-risk patients, especially those with malnutrition. Refeeding syndrome requires careful management, including gradual electrolyte imbalance correction and administration of a thiamine loading dose to prevent or correct refeeding-induced thiamine deficiency.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%