Beriberi history and symptoms: Difference between revisions

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==Overview==
The symptoms of beriberi are usually vague and therefore, the diagnosis must be considered in the clinical and geographical contexts. Common symptoms for wet beriberi include tachycardia, respiratory distress, and edema, while common symptoms for dry beriberi include parasthesia, muscle pain, weakness.


==History and Symptoms==
==History and Symptoms==


*Cardiovascular or wet beriberi is manifested by heart hypertrophy and dilatation (particularly of the right ventricle), [[tachycardia]], respiratory distress, [[edema]] of the legs and [[heart failure]] with high [[cardiac output]]. Severe [[lactic acidosis]] is characteristic (1).
=== History of Beriberi ===


*Neurological or dry beriberi is manifested by exaggeration of [[deep tendon reflexes]], [[polyneuritis]] (sometimes associated with paralysis) that typically affects lower extremities and in a subsequent stage, upper extremities, muscle weakness and pain, and [[convulsions]].
* The majority of beriberi patients usually have no specific symptoms of beriberi.
* Therefore, detailed history in the clinical and geographical context is valuable in these patients.
* The patient should be asked about his diet regimen, alcohol consumption rate, and any surgeries in the past period.
* Family history may be present in rare cases with genetic beriberi in which a genetic mutation interferes with thiamine absorption.<br />


*Gastrointestinal beriberi: Gastrointestinal symptoms are primarily due to the delayed emptying of the stomach and dilation of the [[colon]]. Loss of appetite, vague abdominal complaints, and [[constipation]] are common manifestations. As the disease progresses [[nausea]] and [[vomiting]] may occur.
=== Symptoms of Beriberi ===


*Wernicke-Korsakoff syndrome: [[Wernicke's]] disease is a triad of [[nystagmus]], [[ophthalmoplegia]], and [[ataxia]], along with [[confusion]]. [[Korsakoff's]] [[psychosis]] is impaired short-term memory and confabulation with otherwise grossly normal cognition. This combination is almost exclusively described in chronic [[alcoholic]]s with thiamine deficiency. The two entities are not separate diseases, but a spectrum of signs and symptoms. Genetic abnormalities may underlie a predisposition to [[Wernicke-Korsakoff syndrome]].
*Cardiovascular or wet beriberi is manifested by cardiac hypertrophy and [[Congestive heart failure|heart failure]] with high cardiac output.<ref name="pmid23849362">{{cite journal| author=Chisolm-Straker M, Cherkas D| title=Altered and unstable: wet beriberi, a clinical review. | journal=J Emerg Med | year= 2013 | volume= 45 | issue= 3 | pages= 341-4 | pmid=23849362 | doi=10.1016/j.jemermed.2013.04.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23849362  }}</ref>
**[[Palpitation|Palpitations]]
**Respiratory distress
**[[Edema]] of the legs
**Severe [[lactic acidosis]].


*Bariatric beriberi: Thiamine deficiency after Roux-en-Y [[gastric bypass]] surgery is common. After Roux-en-Y gastric bypass, thiamine deficiency has been reported in 18% of patients at one year post-surgical follow-up in a university hospital setting. Our group previously published that persistent thiamine deficiency is associated with small bowel bacterial overgrowth following gastric bypass surgery. Oral thiamine supplementation does not reverse thiamine deficiency in this patient population. Concurrent treatment of small intestinal bacterial overgrowth with antibiotics is needed to adequately treat the condition.
*Neurological or dry beriberi is manifested by [[polyneuritis]] (sometimes paralysis) that typically starts in the lower limbs and progresses to the upper limbs,
**Parathesia
**Muscle weakness and muscle pain<ref name="pmid308627722">{{cite journal| author=Shible AA, Ramadurai D, Gergen D, Reynolds PM| title=Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature. | journal=Am J Case Rep | year= 2019 | volume= 20 | issue=  | pages= 330-334 | pmid=30862772 | doi=10.12659/AJCR.914051 | pmc=6429982 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30862772  }}</ref>
**[[Convulsions]].


*Psychotic beriberi: Psychotic beriberi manifesting with auditory and visual hallucinations, odd and aggressive behavior has been recently described in gastric bypass patients.
*Gastrointestinal symptoms are due to delayed gastric emptying and colon dilation.
**Loss of appetite,
**Vague abdominal complaints
**[[Constipation]]
**[[Nausea]] and [[vomiting]] in advanced stages.
 
*Wernicke-korsakoff syndrome:  
**[[Wernicke's]] disease is a triad of [[nystagmus]], [[ophthalmoplegia]], and [[ataxia]], along with [[confusion]].
**[[Korsakoff's]] [[psychosis]] is impaired short-term memory and confabulation with otherwise grossly normal cognition.
**This combination is almost exclusively described in chronic [[alcoholic]]s with thiamine deficiency.<ref name="pmid30862772">{{cite journal| author=Shible AA, Ramadurai D, Gergen D, Reynolds PM| title=Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature. | journal=Am J Case Rep | year= 2019 | volume= 20 | issue=  | pages= 330-334 | pmid=30862772 | doi=10.12659/AJCR.914051 | pmc=6429982 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30862772  }}</ref><ref name="pmid30281514">{{cite journal| author=Chandrakumar A, Bhardwaj A, 't Jong GW| title=Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis. | journal=J Basic Clin Physiol Pharmacol | year= 2018 | volume= 30 | issue= 2 | pages= 153-162 | pmid=30281514 | doi=10.1515/jbcpp-2018-0075 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30281514  }}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 15:40, 13 November 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

The symptoms of beriberi are usually vague and therefore, the diagnosis must be considered in the clinical and geographical contexts. Common symptoms for wet beriberi include tachycardia, respiratory distress, and edema, while common symptoms for dry beriberi include parasthesia, muscle pain, weakness.

History and Symptoms

History of Beriberi

  • The majority of beriberi patients usually have no specific symptoms of beriberi.
  • Therefore, detailed history in the clinical and geographical context is valuable in these patients.
  • The patient should be asked about his diet regimen, alcohol consumption rate, and any surgeries in the past period.
  • Family history may be present in rare cases with genetic beriberi in which a genetic mutation interferes with thiamine absorption.

Symptoms of Beriberi

  • Neurological or dry beriberi is manifested by polyneuritis (sometimes paralysis) that typically starts in the lower limbs and progresses to the upper limbs,
  • Gastrointestinal symptoms are due to delayed gastric emptying and colon dilation.

References

  1. Chisolm-Straker M, Cherkas D (2013). "Altered and unstable: wet beriberi, a clinical review". J Emerg Med. 45 (3): 341–4. doi:10.1016/j.jemermed.2013.04.022. PMID 23849362.
  2. Shible AA, Ramadurai D, Gergen D, Reynolds PM (2019). "Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature". Am J Case Rep. 20: 330–334. doi:10.12659/AJCR.914051. PMC 6429982. PMID 30862772.
  3. Shible AA, Ramadurai D, Gergen D, Reynolds PM (2019). "Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke's Encephalopathy Mimicking Guillain-Barré syndrome: A Case Report and Review of the Literature". Am J Case Rep. 20: 330–334. doi:10.12659/AJCR.914051. PMC 6429982. PMID 30862772.
  4. Chandrakumar A, Bhardwaj A, 't Jong GW (2018). "Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis". J Basic Clin Physiol Pharmacol. 30 (2): 153–162. doi:10.1515/jbcpp-2018-0075. PMID 30281514.


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