Histopathological Changes of Biopsied Myocardium in Shoshin Beriberi

Abstract

SUMMARYCardiovascular beriberi is caused by thiamine deficiency and usually arises for one of two reasons: alcoholism or diet. Shoshin beriberi is a fulminant form of cardiac beriberi. We investigated the histopathological features of biopsied myocardial tissue samples from two patients with Shoshin beriberi (one patient with nonalcoholic beriberi and another patient with alcoholic beriberi). Interstitial fibrosis and a variation in size of the myocardial fibers were the main findings in the sample from these patients after thiamine treatment. These findings are persistent histopathological features in the myocardium of patients with Shoshin beriberi after thiamine treatment. (Int Heart J 2005; 46: 751-759)

Cardiac beriberi: morphological findings in two fatal cases

“…Cardiovascular beriberi can also be divided into a fulminant form (Shoshin beriberi) and a chronic form. Shoshin beriberi is characterized by hypotension, tachycardia, and lactic acidosis and is mainly encountered in non-alcoholic patients in Asian countries, although it has also been seen in alcoholics in Western countries [5]. Patients may be critically ill with hypotension, hypothermia, and obtundation.…”

“…Thiamine is considered a clinically important factor in heart function, and its deficiency has been reported to cause heart failure [2-4]. Due to the complex clinical presentation and to the lack of diagnostic tests, thiamine deficiency is still being missed, especially among non-alcoholics patients [5]. …”

Severe anasarca due to beriberi heart disease and diabetic nephropathy

“…However, it can still occur in patients on inadequate diet and excessive alcohol intake [1,2]. Beriberi heart disease is characterized by high-output heart failure associated with peripheral arteriolar vasodilatation and sodium retention, and systemic edema, which mimics other edematous state, including liver cirrhosis, congestive heart failure, and nephrotic syndrome.…”

Properties of thiamin transport in isolated perfused hearts of chronically alcoholic guinea pigsThis article is one of a selection of papers published in the special issue Bridging the Gap: Where Progress in Cardiovascular and Neurophysiologic Research Meet.

“…Mutations in genes for thiamin transporters lead to complex syndromes, such as thiamin-responsive megaloblastic anaemia (TRMA) (an autosomal recessive disorder defined by the occurrence of megaloblastic anaemia), diabetes mellitus, and sensorineural deafness (Fleming et al 1999;Labay et al 1999). Acquired thiamin deficiency syndromes, however, are much more frequent, and one form, called beriberi, is characterized by cardiomyopathy (Kawano et al 2005). A typical underlying condition for the development of thiamin deficiency is alcoholism, although other major diseases, such as diabetes mellitus, are implicated as well (Thornalley et al 2007).…”