Thiamine responsive acute life threatening metabolic acidosis in exclusively breast-fed infants

Qureshi, Umar Amin; Sami, Abdus; Altaf, Uruj; Ahmad, Kaisar; Iqbal, Javeed; Wani, Nisar Ahmad; Mir, Zahid Iqbal; Ali, Iram

doi:10.1016/j.nut.2015.08.007

Cited by 42 publications

(49 citation statements)

References 12 publications

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“…Within hours, even infants with advanced beriberi return to breastfeeding and, within days, their cardiac function returns to normal. Shoshin beriberi is a fulminant form of wet beriberi (acute cardiogenic shock with lactic acidosis multiorgan failure and no edema) and can easily mimic sepsis . Because of uncertainties regarding the diagnostic criteria of TDDs, it may only be possible to diagnosis beriberi after a patient demonstrates significant improvement following treatment with thiamine.…”

Section: Thiamine Deficiency and Its Consequencesmentioning

confidence: 99%

“…Based on existing biomarker studies and case reports of thiamine‐responsive conditions, along with information on the use of polished rice or cassava as primary staples in the diets of many poor households in LMIC, risk of thiamine deficiency is thought to be of potential public health importance in many communities in Southeast Asia (e.g., Cambodia, Laos, and Myanmar), South Asia (e.g., Nepal and Northern India), and West Africa …”

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

“…A number of reports of infantile beriberi have emerged from the northern region of India, where the diet consists largely of polished, unfortified rice . Cases all occurred in infants who were exclusively breastfed, and the majority of mothers followed a customary dietary restriction.…”

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

“…For example, India, a large country with a diverse population, is not identified by FBS data as a country with thiamine deficiency. However, infantile beriberi cases have been reported in recent years in the northern region of Kashmir, where diets consist largely of polished rice . The ability to disaggregate dietary data for specific population subgroups can be useful in assessing the risk for thiamine deficiency.…”

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

See 3 more Smart Citations

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

241

335

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Thiamine is an essential micronutrient that plays a key role in energy metabolism. Many populations worldwide may be at risk of clinical or subclinical thiamine deficiencies, due to famine, reliance on staple crops with low thiamine content, or food preparation practices, such as milling grains and washing milled rice. Clinical manifestations of thiamine deficiency are variable; this, along with the lack of a readily accessible and widely agreed upon biomarker of thiamine status, complicates efforts to diagnose thiamine deficiency and assess its global prevalence. Strategies to identify regions at risk of thiamine deficiency through proxy measures, such as analysis of food balance sheet data and month-specific infant mortality rates, may be valuable for understanding the scope of thiamine deficiency. Urgent public health responses are warranted in high-risk regions, considering the contribution of thiamine deficiency to infant mortality and research suggesting that even subclinical thiamine deficiency in childhood may have lifelong neurodevelopmental consequences. Food fortification and maternal and/or infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of infantile beriberi in regions where thiamine deficiency is prevalent, but trial data are limited. Efforts to determine culturally and environmentally appropriate food vehicles for thiamine fortification are ongoing.

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Section: Thiamine Deficiency and Its Consequencesmentioning

confidence: 99%

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 99%

See 2 more Smart Citations

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

241

335

View full text Add to dashboard Cite

show abstract

“…The clinical spectrum of TD may vary according to the clinical setting, age, and individual susceptibility (13). Infantile beriberi typically presents as heart failure, dysphonia, and increased irritability (5, 14, 15). However, the classical diagnostic criteria for infantile beriberi may be non-specific for diagnosis of TD in endemic regions, where the disease may often be clinically unapparent (5).…”

mentioning

confidence: 99%

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

2017

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Descriptive spectrum of thiamine deficiency in pregnancy: A potentially preventable condition

Nisar

Kareem

Muzaffer

et al. 2023

Intl J Gynecology & Obste

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ObjectivePregnancy, a nutritionally demanding situation in terms of macro‐ and micronutrient supply owing to heightened maternal, placental, and fetal needs, significantly affects thiamine reserves. Thiamine deficiency during pregnancy and the postpartum period, presenting with varied manifestations and outcomes, is a relatively common condition in our population. The study aimed to understand the various manifestations and outcomes of acute thiamine deficiency in pregnant and postpartum women, emphasizing the significance of early recognition and thiamine therapy to prevent serious complications during pregnancy and after childbirth.MethodsThis prospective study conducted in a tertiary care center in North India enrolled consecutive pregnant and postpartum women presenting with clinical features consistent with thiamine deficiency disorders, such as thiamine deficiency‐related neuropathy, high‐output heart failure, heart failure with reduced ejection fraction, Wernicke's encephalopathy, gastric beriberi, and thiamine‐responsive acute pulmonary hypertension. In addition to capturing medical history including drug intake, dietary consumption, and comorbidities, women underwent brief relevant clinical examinations and laboratory assessments, including whole‐blood thiamine levels. Response to intravenous thiamine supplementation was also monitored.ResultsData of 31 women (12 pregnant, 19 postpartum) with a diagnosis of acute thiamine deficiency and a mean age of 28.88 ± 2.69 years were analyzed. The mean thiamine level was 1.28 ± 0.44 μg/dL with mean blood lactate of 3.46 ± 3.33. The most common presentation was gastric beriberi (n = 10), followed by paraparesis (n = 6), high‐output heart failure (n = 6), acute pulmonary hypertension, heart failure with reduced ejection fraction (n = 3 each), and an acute confusional state (n = 2). All patients responded to thiamine challenge.ConclusionIn the context of borderline thiamine status, particularly in our population with endemic thiamine deficiency and heightened demand for thiamine during pregnancy and the peripartum period, the deficiency can have varied and serious manifestations of dry and wet beriberi. Early recognition of the clinical features and thiamine therapy can be life‐saving. There is a need for validated clinical criteria owing to the non‐availability of thiamine testing in resource‐limited settings.

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Thiamine responsive acute life threatening metabolic acidosis in exclusively breast-fed infants

Cited by 42 publications

References 12 publications

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs

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

Descriptive spectrum of thiamine deficiency in pregnancy: A potentially preventable condition

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