Thiamine deficiency can have cardiovascular and neurological manifestations. Cardiac beriberi is classically thought to represent a high-output state with oliguria and lactic acidosis. The condition can, however, also present itself with a low cardiac output and fulminant vascular collapse, or as an acute fatal form, causing sudden death, without clear-cut signs of cardiomegaly. In the western society beriberi is mainly encountered in alcoholics. We report on two cases, one with high-output failure and the other with low-output failure and cardiovascular collapse. In both patients the diagnosis of shoshin syndrome was made, and and both showed a spectacular improvement of congestive heart failure symptoms after treatment with thiamine. A therapeutic trial with thiamine is the only way to rapid diagnosis.
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Shoshin Beriberi in a Child With Intestinal Failure: A Case Report.
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Vitamin B1 Deficiency and Perimyocarditis Fulminans: A Case Study of Shoshin Syndrome in a Woman Following an Unbalanced Dietary Pattern Followed by a Literature Review.
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Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland.
(1) Background: vitamin B1 level depletion, known as a beriberi syndrome, can lead to severe cardiovascular complications, from which perimyocarditis fulminans is one of the most severe. (2) Methods: this is a retrospective case study that includes an adult patient with clinical presentations of acute heart failure (HF) symptoms following perimyocarditis on the grounds of thiamine deficiency. (3) Results: A 49-year-old woman presented with acute HF symptoms due to perimyocarditis.
View Article and Find Full Text PDFInvestigating oxythiamine levels in children undergoing kidney transplantation and the risk of immediate post-operative metabolic and hemodynamic decompensation.
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University of British Columbia (Pediatrics), Vancouver, British Columbia, Canada.
Background: Oxythiamine is a uremic toxin that acts as an antimetabolite to thiamine and has been associated with cases of Shoshin beriberi syndrome in adults. We sought to identify whether surgical stress and ischemia/reperfusion injury may precipitate functional thiamine deficiency in children peritransplant.
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Acute Shoshin beriberi syndrome immediately post-kidney transplant with rapid recovery after thiamine administration.
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Multi Organ Transplant Program, BC Children's Hospital, Vancouver, British Columbia, Canada.
Article Synopsis
- - Pediatric kidney transplant surgeries generally go smoothly, but children may face complications from poor physical health due to end-stage kidney failure, requiring nutritional support to help with deficiencies, especially when on dialysis.
- - A case study of a 14-year-old boy who developed severe cardiac and metabolic issues after a kidney transplant revealed thiamine deficiency as a critical problem, likely exacerbated by prior inadequate dialysis which led to the accumulation of toxins.
- - The patient responded rapidly to intravenous thiamine treatment, marking the first documented instance of Shoshin beriberi syndrome in a pediatric kidney transplant patient, suggesting that thiamine deficiency should be evaluated in similar cases of post-transplant instability.
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Pediatric Intensive Care Department, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.
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.
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