Shoshin beriberi: an underdiagnosed condition?

Pang, Joseph; Yardumian, A.; Davies, R.; Patterson, David

doi:10.1007/bf00292932

Cited by 30 publications

(12 citation statements)

References 9 publications

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“…From a clinical perspective, the I-Lan outbreak illustrates the importance of considering vitamin deficiency in the differential diagnosis of illness, especially among patients whose diets are very restricted or unusual, such as alcoholics, patients reliant on total parenteral nutrition, or those on very severe weight loss diets. 5,6,7,26 Unless beriberi is considered in the differential diagnosis of neuropathy, high output cardiac failure, lactic acidosis, or shock, an easily treated, potentially fatal condition may be overlooked.…”

Section: Discussionmentioning

confidence: 99%

Outbreak of Beriberi Among Illegal Mainland Chinese Immigrants at a Detention Center in Taiwan

Chen

Twu²,

Chiou³

et al. 2003

Public Health Reports

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Objective. The authors describe an outbreak of beriberi in a detention center in Taiwan and examine risk factors for illness. Methods.A survey was conducted among a sample of 176 randomly selected detainees. A menu-assisted dietary recall method was used to obtain diet information from nine hospitalized detainees. A probable case patient was defined as an individual who had at least two of the following characteristics: leg edema, weakness of the extremities, poor appetite, and dyspnea. Possible case patients were those who had only one of these characteristics.Results. Of the 176 survey respondents, 19% were classified as probable case patients and 40% as possible case patients. The mortality rate based on probable cases was 1.1%. Body Mass Index (BMI) was negatively associated with illness (pϽ0.0001), and length of stay in the detention center was independently positively associated with illness (pϽ0.05). The average intake of dietary thiamine among the nine hospitalized case patients who completed three-day dietary recall surveys was 0.49Ϯ0.1 mg/day. After thiamine administration, all symptoms and signs of beriberi resolved.Conclusion. This outbreak is a reminder of the importance of ensuring adequate diets for poor, institutionalized, or refugee populations who are unable to supplement their diets.

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Section: Discussionmentioning

confidence: 99%

Outbreak of Beriberi Among Illegal Mainland Chinese Immigrants at a Detention Center in Taiwan

Chen

Twu²,

Chiou³

et al. 2003

Public Health Reports

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“…In its most fulminant form, this condition is characterized by hypotension, tachycardia and lactic acidosis. If untreated, patients die within hours from circulatory collapse and pulmonary edema [3]. This condition often goes unrecognized since it is easily confused with other illnesses.…”

Section: Case Presentationmentioning

confidence: 99%

Cardiovascular magnetic resonance in wet beriberi

Essa

Velez

Smith

et al. 2011

Journal of Cardiovascular Magnetic Resonance

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The clinical presentation of beriberi can be quite varied. In the extreme form, profound cardiovascular involvement leads to circulatory collapse and death. This case report is of a 72 year-old male who was admitted to the Neurology inpatient ward with progressive bilateral lower extremity weakness and parasthesia. He subsequently developed pulmonary edema and high output cardiac failure requiring intubation and blood pressure support. With the constellation of peripheral neuropathy, encephalopathy, ophthalmoplegia, unexplained heart failure, and lactic acidosis, thiamine deficiency was suspected. He was empirically initiated on thiamine replacement therapy and his thiamine level pre-therapy was found to be 23 nmol/L (Normal: 80-150 nmol/L), consistent with the diagnosis of beriberi. Cardiovascular magnetic resonance (CMR) showed severe left ventricular systolic dysfunction, markedly increased myocardial T2, and minimal late gadolinium enhancement (LGE). After 5 days of daily 100 mg IV thiamine and supportive care, the hypotension resolved and the patient was extubated and was released from the hospital 3 weeks later. Our case shows via CMR profound myocardial edema associated with wet beriberi.

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“…Owing to its short storage cycle, marginal thiamine deficiency can occur as early as 10 days after deprivation (Finglas, 1993). Symptoms of beriberi include poor appetite, fatigue, peripheral neuritis and in some cases edema and cardiac failure (Engbers, et al, 1984;Pang et al, 1986). Severe thiamine deficiency is linked to two classical conditions: beriberi and Wernicke-Korsakoff syndrome.…”

Section: Introductionmentioning

confidence: 99%

Ion pair liquid chromatography method for the determination of thiamine (vitamin B1) homeostasis

Basiri

Sutton

Hanberry

et al. 2015

Biomedical Chromatography

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A new method for reversed phase HPLC determination of thiamine and its major in vivo phosphorylation products, thiamine monophosphate (TMP) and thiamine pyrophosphate (TPP), was developed using tetrabutylammonium hydroxide as the ion-pairing agent. The separation was performed on a Phenomenex Kinetex EVO C18 column with a gradient of a phosphate-buffered aqueous solution of the ion-pair reagent and methanol. The duty cycle for the assay was 13 min and pyrithiamine was successfully used as the internal standard for the first time in a thiamine HPLC measurement protocol. Detection of the fluorescence derivatives of the analytes as well as the IS allowed for lower detection limits in order to support biological applications in cell culture models. The linearity, sensitivity, specificity, accuracy and precision of the method were evaluated and met the requirements specified by the US Food and Drug Administration. The calibration curves proved to be linear and the method was validated over the range from 1.0-4000 nM for both cells and the media where complete recovery of the analytes was also achieved.

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Shoshin beriberi: an underdiagnosed condition?

Cited by 30 publications

References 9 publications

Outbreak of Beriberi Among Illegal Mainland Chinese Immigrants at a Detention Center in Taiwan

Outbreak of Beriberi Among Illegal Mainland Chinese Immigrants at a Detention Center in Taiwan

Cardiovascular magnetic resonance in wet beriberi

Ion pair liquid chromatography method for the determination of thiamine (vitamin B1) homeostasis

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