Journal article
Atypical presentation of a forgotten disease: refractory hypotension in beriberi
European journal of clinical nutrition, Vol.73(12), pp.1598-1600
12/01/2019
DOI: 10.1038/s41430-019-0469-y
PMID: 31285553
Abstract
Thiamine deficiency is a treatable disease with an excellent prognosis. However, it is often unrecognized because of the diversity of its clinical presentations.
Herein, we report two atypical cases of nonalcoholic thiamine deficiency that presented with refractory hypotension in the absence of lactic acidosis.
Case 1 developed recurrent hypotension, right-sided heart failure, and a classic triad of Wernicke's encephalopathy (WE) after gastrointestinal surgery. Case 2 had decreased dietary intake and diuretic abuse, and had multiple episodes of syncope prior to present admission with refractory hypotension and mental status changes. The diagnosis of both cases was confirmed by undetectable pretreatment serum thiamine and dramatic improvement with thiamine replacement.
In this report, we highlight refractory hypotension as a complication of, not only cardiovascular, but also neurologic beriberi. Moreover, thiamine replacement should be considered without delay in hypotensive patients with signs of WE and/or risk factors for beriberi.
Details
- Title: Subtitle
- Atypical presentation of a forgotten disease: refractory hypotension in beriberi
- Creators
- Pavida Pachariyanon - Texas Tech University Health Sciences CenterSmathorn Thakolwiboon - Texas Tech UniversityArunee Motes - Texas Tech University Health Sciences CenterJ Drew Payne - Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USAKenneth Nugent - Texas Tech University Health Sciences Center
- Resource Type
- Journal article
- Publication Details
- European journal of clinical nutrition, Vol.73(12), pp.1598-1600
- DOI
- 10.1038/s41430-019-0469-y
- PMID
- 31285553
- ISSN
- 0954-3007
- eISSN
- 1476-5640
- Language
- English
- Date published
- 12/01/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691515502771
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