Thiamine Metabolism

Thiamine Deficiency and Hepatorenal Syndrome

“…Several years ago we found that RBC transketolase activ ity (TKA), an enzyme dependent on thiamine [3], was normal in decompensated cirrhotic patients as compared to that of healthy volunteers and chronically ill non-cirrhotic patients [4], The study was prompted by similari ties observed between some patients with cirrhosis and those with beriberi (hyperdynamic circulation with ele vated cardiac output, and metabolic acidosis with ele vated blood lactate and pyruvate levels), and because of the possibility of an impaired capacity to convert thia mine to its active form (thiamine pyrophosphate, TTP) in cirrhosis [5]. Now we report here the evaluation of thiamine defi ciency in five cirrhotic patients with the HRS (group 1) (table I).…”

“…However, the results in patients C and D, obtained after only 3 days of hospitalization, militate against this possibility. Be cause of the prominent role of thiamine as an essential cofactor in intermediary metabolism [5,9], the import ance of aggressive and ample thiamine supplemen tation should be emphasized in patients with severe liver disease, either of alcoholic or other etiologies [2,7,8]. This, of course, may not prevent the appearance of the HRS.…”

Red Blood Cell Transketolase Activity and Blood Lactate and Pyruvate in Patients with Cirrhosis of the Liver

“…Williams and Bissell [25] have suggested that these patients have an impaired capacity to convert thiamine to its active form thiamine pyrophosphate, TPP.…”