Infant Botulism: Is There an Association With Thiamine Deficiency?

Ringe, Hannelore; Schuelke, Markus; Weber, Sven C.; Dorner, Brigitte G.; Kirchner, Sebastian; Dorner, Martin B.

doi:10.1542/peds.2013-3378

Cited by 13 publications

(13 citation statements)

References 26 publications

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“…Regular consumption of foods containing thiamine antagonists, such as betel nut or tea leaves, and thiaminases in foods such as raw fish and African silkworm larvae, have also been implicated as precipitants of thiamine deficiency . Some bacteria (e.g., Clostridium botulinum ) are also capable of producing thiaminases . Conditions that lead to food insecurity, including drought, conflict, displacement due to war, famine, or natural disaster, as well as severe acute malnutrition (SAM), raise the risk of deficiency .…”

Section: Thiamine Deficiency and Its Consequencesmentioning

confidence: 99%

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

231

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%

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

231

335

View full text Add to dashboard Cite

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“…It was speculated that the paralysis of this patient due to clostridium neurotoxins was in fact aggravated by TD. Indeed, the administration of thiamine resulted in faster improvement and a shorter clinical course ( 121 ).…”

Section: Syndromes Of Td In Childrenmentioning

confidence: 99%

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

Hiffler¹,

Rakotoambinina

Lafferty

et al. 2016

Front. Nutr.

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In humans, thiamine is a micronutrient prone to depletion that may result in severe clinical abnormalities. This narrative review summarizes current knowledge on thiamine deficiency (TD) and bridges the gap between pathophysiology and clinical presentation by integrating thiamine metabolism at subcellular level with its function to vital organs. The broad clinical spectrum of TD is outlined, with emphasis on conditions encountered in tropical pediatric practice. In particular, TD is associated with type B lactic acidosis and classic forms of beriberi in children, but it is often unrecognized. Other severe acute conditions are associated with hypermetabolism, inducing a functional TD. The crucial role of thiamine in infant cognitive development is also highlighted in this review, along with analysis of the potential impact of TD in refeeding syndrome during severe acute malnutrition (SAM). This review aims to increase clinical awareness of TD in tropical settings where access to diagnostic tests is poor, and advocates for an early therapeutic thiamine challenge in resource-limited settings. Moreover, it provides evidence for thiamine as treatment in critical conditions requiring metabolic resuscitation, and gives rationale to the consideration of increased thiamine supplementation in therapeutic foods for malnourished children.

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“…Other risk factors include the ingestion by breastfeeding mothers or older children of antithiamine agents, such as tea leaves, betel nuts, and coffee, and the ingestion of thiaminases in raw fish and some insect larvae that inactivate thiamine . Some bacteria, such as Clostridium species, have been identified as producing thiaminases …”

Section: Conditions and Risk Factors Leading To Thiamine Deficiency Imentioning

confidence: 99%

“…17,18 Some bacteria, such as Clostridium species, have been identified as producing thiaminases. 19,20 Reduced intestinal absorptive capacity during environmental enteropathy and malnutrition may also lead to thiamine insufficiency (subclinical low vitamin B 1 levels). 21 Gut microbiota is also affected in malnourished children, which might affect thiamine-uptake capacity.…”

Section: Conditions and Risk Factors Leading To Thiamine Deficiency Imentioning

confidence: 99%

Thiamine content of F‐75 therapeutic milk for complicated severe acute malnutrition: time for a change?

Hiffler¹,

Adamolekun

Fischer

et al. 2017

Annals of the New York Academy of Sciences

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Since community-based management of severe acute malnutrition has become the standard of care, the clinical profile of severe acutely malnourished patients admitted to hospitals or inpatient therapeutic feeding centers has changed significantly. These patients are usually very ill and often present with several comorbidities, such as shock, sepsis, and pneumonia. Complicated severe acute malnutrition patients are at risk of thiamine insufficiency, and critically ill patients have higher thiamine requirements. The thiamine content of F-75, the therapeutic milk formula used in the early stabilization phase of refeeding in patients with severe acute malnutrition, seems insufficient. Here, we discuss the need and rationale for a substantial increase in the thiamine content of F-75.

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Infant Botulism: Is There an Association With Thiamine Deficiency?

Cited by 13 publications

References 26 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

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

Thiamine content of F‐75 therapeutic milk for complicated severe acute malnutrition: time for a change?

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