AI Article Synopsis

  • * A case study of a 45-year-old woman showed altered mental status, nausea, vomiting, and weakness; her condition was attributed to a thiamine deficiency due to prolonged vomiting and poor nutrition, while other potential causes were ruled out.
  • * After treatment with thiamine, the patient's condition improved significantly, underscoring the need for healthcare providers to consider thiamine deficiency in cases of malnutrition related to digestive issues and neurological symptoms, even though it's

Article Abstract

Introduction: Thiamine deficiency, also known as beriberi, is a nutritional disorder caused by a lack of thiamine (vitamin B) in the diet. It can occur in 2 forms: dry beriberi, which affects the nervous system, and wet beriberi, which affects the cardiovascular system. Gastrointestinal beriberi is a subtype that affects the digestive system and can lead to multisystem involvement. In the United States (US), thiamine deficiency often arises from chronic malnutrition secondary to alcoholism, known as Wernicke-Korsakoff Syndrome.

Case Presentation: A 45-year-old female with no known past medical history or alcohol use disorder came to the emergency department with an altered mental status and with a history of intractable nausea and vomiting for several months prior to presentation. During intake, the medical team discovered she had bilateral lower extremity weakness and an anion gap metabolic acidosis. Her inpatient workup ruled out meningitis, encephalitis, peritonitis, diabetic ketoacidosis, and cerebrovascular accident. A thiamine deficiency was the most probable cause of her presentation, secondary to her protracted history of vomiting and poor oral medication intake. Refeeding syndrome complicated her hospitalization. After replenishing thiamine, the patient experienced significant improvement in mental status and lower extremity weakness. The healthcare team later discharged her with home physical therapy rehabilitation and nutritional counseling.

Conclusion: Thiamine deficiency is not common in the US. However, this case highlights the importance of including this deficiency in the differential when a patient arrives with a history of malnourishment secondary to a gastrointestinal illness with signs of altered mental status and neurological symptoms.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229594PMC
http://dx.doi.org/10.36518/2689-0216.1649DOI Listing

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