Shoshin Beriberi in Critically-Ill patients: case series

Dabar, Georges; Harmouche, Carine; Habr, Bassem; Riachi, Moussa; Jaber, Bertrand L.

doi:10.1186/s12937-015-0039-7

Cited by 38 publications

(49 citation statements)

References 18 publications

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“…Direct impairment of myocardial energy production has been proposed as a possible basis for the development of heart failure state seen in beriberi (because of loss of thiamine's beneficial role in metabolic reactions) [6]. Decreased activity of pyruvate dehydrogenase due to thiamine deficiency results in build-up of pyruvate, which is then shunted towards anaerobic conversion into lactate [7]. This accumulation of lactate causes a decrease in peripheral resistance, thereby increasing venous return to the heart (preload).…”

Section: Introductionmentioning

confidence: 99%

Thiamine Therapy for Heart Failure: a Promise or Fiction?

Kattoor

Goel

Mehta

2018

Cardiovasc Drugs Ther

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Section: Introductionmentioning

confidence: 99%

Thiamine Therapy for Heart Failure: a Promise or Fiction?

Kattoor

Goel

Mehta

2018

Cardiovasc Drugs Ther

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“…In some cases, heart failure may be followed by decreased cardiac output and shock. Hemodynamic deterioration is accompanied by markedly increased lactate levels and acidosis . This form of wet beriberi is the most severe and is known as Shoshin beriberi (from the Japanese sho = acute, shin = heart).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Role of Thiamin in Health and Disease

et al. 2019

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Thiamin is a hydrosoluble vitamin that plays a role in several biological processes, mainly in glucose metabolism. There are several risk factors for developing thiamin deficiency, such as malnutrition, refeeding syndrome, gastrointestinal surgery, and alcoholism. Recently, the role of thiamin in critically ill patients has gained prominence, and the prevalence of thiamin deficiency was found to be increased in patients with severe burns, major surgery, septic shock, end-stage renal disease, and heart failure. In adults, thiamin deficiency presents as encephalopathy, dry beriberi (with neurological signs and symptoms), or wet beriberi (with cardiovascular signs and symptoms). Thiamin deficiency can be diagnosed clinically, and all clinicians should be aware of this disease, especially in patients with risk factors for thiamin deficiency. Thiamin supplementation should be started as early as possible in patients suspected to have thiamin deficiency. Treatment is safe, inexpensive, simple, and life-saving. Diagnosis is confirmed on a positive response to treatment. (Nutr Clin Pract. 2019;34:558-564)

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“…The syndrome of Shoshin beriberi is the most severe manifestation of acute thiamine deficiency, characterized by hemodynamic collapse with cardiac dysfunction, type B lactic acidosis, and hyperglycemia . These symptoms stem in part from impaired transketolase activity, affecting carbohydrate metabolism and the pentose monophosphate pathway .…”

Section: Introductionmentioning

confidence: 99%

Acute Shoshin beriberi syndrome immediately post–kidney transplant with rapid recovery after thiamine administration

Elias

Sinclair

Blydt‐Hansen

2019

Pediatric Transplantation

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Pediatric kidney transplant surgery is usually well tolerated, despite suboptimal physical conditioning that may result from uremia and nutritional deficiencies that accompany end‐stage kidney failure. Nutritional supplementation is used to overcome such deficiencies, especially for children needing dialysis. Thiamine, a water‐soluble vitamin also known as vitamin B1, is a critical cofactor in energy metabolism and may be competitively inhibited by the antimetabolite oxythiamine, a uremic toxin that accumulates in kidney failure. We report a case of a thiamine deficiency syndrome leading to overwhelming cardiac dysfunction, metabolic instability, and hemodynamic compromise, after otherwise uneventful kidney transplant surgery. Prior to transplant, this 14‐year‐old boy was treated with peritoneal dialysis and received thiamine supplementation. Post‐transplant, the patient first developed hyperglycemia, then lactic acidosis, and subsequently hemodynamic instability despite escalating treatment with volume resuscitation and inotropic medication. He made a rapid and complete recovery after administration of IV thiamine. This is the first reported case of Shoshin beriberi syndrome in a pediatric kidney transplant recipient. Inadequate dialysis may have been a key factor, with toxin accumulation and thiamine transporter downregulation contributing to his status. Functional thiamine deficiency should be considered as a potential treatable cause of early post‐transplant hemodynamic instability.

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Shoshin Beriberi in Critically-Ill patients: case series

Cited by 38 publications

References 18 publications

Thiamine Therapy for Heart Failure: a Promise or Fiction?

Thiamine Therapy for Heart Failure: a Promise or Fiction?

Role of Thiamin in Health and Disease

Acute Shoshin beriberi syndrome immediately post–kidney transplant with rapid recovery after thiamine administration

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