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| | __NOTOC__ |
| | {{Beriberi}} |
| | '''For patient information, click [[{{PAGENAME}} (patient information)|here]]''' |
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| | '''For more information about on Wet beriberi, click [[Wet beriberi|here]]''' |
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| {{Infobox_Disease | | | {{Infobox_Disease | |
| Name = Beriberi | | | Name = Beriberi | |
| Image = Beriberi U SNLM.jpg | | | Image = Beriberi U SNLM.jpg | |
| Caption = A sufferer - Turn of the 20th Century in southeast Asia | | | Caption = A sufferer - Turn of the 20th Century in southeast Asia | |
| DiseasesDB = 14107 |
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| ICD10 = {{ICD10|E|51|1|e|50}} |
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| ICD9 = {{ICD9|265.0}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = ped |
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| eMedicineTopic = 229 |
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| eMedicine_mult = {{eMedicine2|med|221}} |
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| MeshID = D001602 |
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| }} | | }} |
| {{SI}}
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| '''Editor-In-Chief:''' Timothy R. Koch, M.D., Professor of Medicine, Gastroenterology, Georgetown University School of Medicine. You can email Dr. Koch [mailto:Timothy.R.Koch@MedStar.net here]
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| '''Contributors:''' [[C. Michael Gibson, M.S., M.D.]]
| | {{CMG}}; {{AIA}}; [[User:TimothyKoch|Timothy R. Koch, M.D., Professor of Medicine, Gastroenterology, Georgetown University School of Medicine]]. You can email Dr. Koch [mailto:Timothy.R.Koch@MedStar.net here]; Bikram Bal, M.D., Section of Gastroenterology, Washington Hospital Center. |
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| {{Editor Join}} | | {{SK}} Thiamine (Vitamin B1) deficiency; Wericke disease; Korsakoff disease; Korsakov disease |
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| ==Overview== | | ==[[Beriberi overview|Overview]]== |
| '''Beriberi''' is a [[nervous system]] and cardiovascular ailment caused by [[thiamine]] (vitamin B<sub>1</sub>) deficiency.
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| ==Etymology== | | ==[[Beriberi historical perspective|Historical Perspective]]== |
| The origin of the word is from a Sinhalese phrase meaning "I cannot, I cannot", the word being doubled for emphasis.<ref>http://www.faqs.org/health/topics/40/Beriberi.html</ref>
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| ==History== | | ==[[Beriberi classification|Classification]]== |
| [[Christiaan Eijkman]] a Dutch [[physician]] and [[pathologist]] first demonstrated that [[beriberi]] is caused by poor diet led to the discovery of [[vitamin]]s. Together with Sir [[Frederick Hopkins]], he was awarded the 1929 [[Nobel Prize for Physiology or Medicine]] for the discovery. | |
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| ==Causes== | | ==[[Beriberi pathophysiology|Pathophysiology]]== |
| Beriberi is caused by a lack of [[thiamine]] (vitamin B<sub>1</sub>). It is common in people whose [[diet (nutrition)|diet]] consists mainly of polished white rice, which is very low in thiamine because the thiamine-bearing husk has been removed. It is also seen in chronic [[alcoholism|alcoholic]]s with an inadequate diet, as well as being a rare side effect of [[gastric bypass surgery]]. If a baby is mainly fed on the [[milk]] of a mother who suffers from thiamine deficiency then that child may develop beriberi.
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| The disease has been seen traditionally in people in Asian countries (especially in the 19th century and before), due to those countries' reliance on white rice as a staple food. Beri-beri is a nutritional disorder caused by deficiency of vitamin B charactarized by damage to nerves and heart; general symptoms include [[loss of appetite]] and feeling of [[lassitude]].
| | ==[[Beriberi causes|Causes]]== |
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| ==Pathophysiology== | | ==[[Beriberi differential diagnosis|Differentiating Beriberi from other Diseases]]== |
| Thiamine deficiency is associated with high output [[heart failure]] due to the [[vasodilation]] that develops as a result of [[pyruvate]] and [[lactate]] accumulation <ref>Attas M, Hanley HG, Stultz D, Jones MR, McAllister RG. Fulminant beriberi heart disease with lactic acidosis. Presentation of a case with evaluation of left ventricular function and review of pathophysiologic mechanisms. Circulation 58: 566–572, 1978.</ref>.
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| ==Diagnosis== | | ==[[Beriberi epidemiology and demographics|Epidemiology and Demographics]]== |
| === Symptoms===
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| Its [[symptom]]s include [[weight loss]], [[emotion]]al disturbances, impaired [[sense|sensory]] [[perception]] ([[Wernicke's encephalopathy]]), [[muscle weakness|weakness]] and [[pain and nociception|pain]] in the limbs, and periods of irregular [[heart rate]]. [[Edema]] (swelling of [[human anatomy|bodily]] tissues) is common. In advanced cases, the [[disease]] may cause [[heart failure]] and [[death]].
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| It may also increase the amount of lactic and pyruvic acids in the blood.
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| There are two forms of the disease: '''wet beriberi''' and '''dry beriberi'''.
| | ==[[Beriberi Risk factors|Risk factors]]== |
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| * '''Wet beriberi''' affects the [[heart]]; it is sometimes fatal, as it causes a combination of [[congestive heart failure|heart failure]] and weakening of the [[capillary]] walls (see [[capillary leak syndrome]]), which causes the peripheral tissues to become edematous.
| | ==[[Beriberi screening|Screening]]== |
| * '''Dry beriberi''' causes wasting and partial [[paralysis]] resulting from damaged peripheral [[nerve]]s. It is also referred to as ''endemic neuritis''.
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| ===Signs=== | | ==[[Beriberi natural history, complications and prognosis|Natural History, Complications, and Prognosis]]== |
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| ===Electrocardiogram=== | | ==Diagnosis== |
| In some studies beriberi heart disease has been associated with a variety of ECG changes including [[sinus tachycardia]] , [[T wave]] inversion, low voltage, [[prolognation of the QT interval]], and either prolongation or shortening of the [[PR interval]] <ref> Brankenhorn MA, Vilter CF, Scheinker IM, Austin RS. Occidental beriberi heart disease. J Am Med Associat 131: 717–726, 1946. </ref> <ref>Weiss S, Wilkins RW. The nature of the cardiovascular disturbances in nutritional deficiency states. Ann Intern Med 11: 104–148, 1937.</ref>. In many cases, these abnormalities revert with treatment of the thiamine deficiency.
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| <ref> Keefer CS. The beriberi heart. Arch Intern Med 45: 1–22, 1930.</ref>
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| <ref>Sukumalchantra Y, Tanphaichitr V, Thongnitr V, Jumbala B. Serial electrocardiographic changes in cardiac beriberi. J Med Assoc Thai 57: 80–88, 1974.</ref>
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| <ref>Seta T, Okuda K, Toyama T, Himeno Y, Ohta M, Hamada M. Shoshin beriberi with severe metabolic acidosis. South Med J 74: 1127–1130, 1981. </ref>
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| The mechanism by which thiamine deficiency results in [[ST elevation]] is not clear. Thiamine deficiency induces ATP depletion and it has been speculated that myocardial energy depletion may result in damage to the myocyte and thereby induce ST elevation.
| | [[Beriberi history and symptoms|History and Symptoms]] | [[Beriberi physical examination|Physical Examination]] | [[Beriberi laboratory findings|Laboratory Findings]] | [[Beriberi electrocardiogram|Electrocardiogram]] | [[Beriberi x ray|X Ray]] | [[Beriberi CT|CT]] | [[Beriberi MRI|MRI]] | [[Beriberi ultrasound|Ultrasound]] | [[Beriberi other imaging findings|Other Imaging Findings]] | [[Beriberi other diagnostic studies|Other Diagnostic Studies]] |
| <ref>Bakker SJ, Leunissen KM. Hypothesis on cellular ATP depletion and adenosine release as causes of heart failure and vasodilatation in cardiovascular beriberi. Med Hypotheses 45: 265–267, 1995. </ref>
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| ==Treatment== | | ==Treatment== |
| Treatment is with [[thiamine hydrochloride]], either in tablet form or injection. A rapid and dramatic recovery within hours can be made when this is administered to patients with beriberi, and their health can be transformed within an hour of administration of the treatment. Thiamine occurs naturally in unrefined cereals and fresh foods, particularly fresh meat, legumes, green vegetables, fruit, and milk.
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| == References ==
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| {{reflist|2}}
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| ==Additional Resources==
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| {{refbegin|2}}
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| * [http://www.whonamedit.com/doctor.cfm/1983.html Christiaan Eijkman bio at whonamedit.com]: discovered cause of Beriberi.
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1600294 A protection against beriberi]. British Medical Journal. 1980 January 19; 280(6208): 187.
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| * [http://0-www.nlm.nih.gov.catalog.llu.edu/medlineplus/ency/article/000339.htm Medical Encyclopedia], [[Medline]], [[National Institutes of Health]].
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| * [http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/beriberi.jsp Health A-to-Z: Beriberi].
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| * [http://www.emedicine.com/ped/topic229.htm L Arturo Batres, MD. Beriberi.EMedicine.com]
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| * NAS: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington DC: National Academy Press; 1998.
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| * Angstadt JD, Bodziner RA: Peripheral polyneuropathy from thiamine deficiency following laparoscopic Roux-en-Y gastric bypass. Obes Surg 2005 Jun-Jul; 15(6): 890-2
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1044535 Beriberi, white rice, and vitamin B: a disease, a cause, and a cure] Reviewed by Sanjoy Bhattacharya. Medical History. 2002 July; 46(3): 432–433.
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1034718 Toward the Conquest of Beriberi], Reviewed by C. A. Bozman. Medical History. 1962 April; 6(2): 198–199.
| | [[Beriberi medical therapy|Medical Therapy]] | [[Beriberi surgery|Surgery]] | [[Beriberi primary prevention|Primary Prevention]] | [[Beriberi secondary prevention|Secondary Prevention]] | [[Beriberi cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Beriberi future or investigational therapies|Future or Investigational Therapies]] |
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1081945 K C Carter The germ theory, beriberi, and the deficiency theory of disease]. Medical History. 1977 April; 21(2): 119–136.
| | ==Case Studies== |
| | [[Beriberi case study one|Case #1]] |
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1796410 A K Clarke. Beriberi in Bethnal Green]. British Medical Journal. 1971 May 1; 2(5756): 278.
| | ==Related Chapters== |
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| * Curran JS, Lewis AB: Vitamin Deficiencies and Excesses. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. 2000: 179.
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| * Djoenaidi W, Notermans SL, Verbeek AL: Subclinical beriberi polyneuropathy in the low income group: an investigation with special tools on possible patients with suspected complaints. Eur J Clin Nutr 1996 Aug; 50(8):549-55
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=481553 J G Engbers, G P Molhoek, and A C Arntzenius. Shoshin beriberi: a rare diagnostic problem]. British Heart Journal. 1984 May; 51(5): 581–582.
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| * [http://findarticles.com/p/articles/mi_qa3912/is_200604/ai_n16350305 Alan Hawk. The Great Disease Enemy, Kak'ke (Beriberi) and the Imperial Japanese Army], Military Medicine, Apr 2006 .
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| * Hirshfeld AB, Getachew A, Sessions J: Drug doses. In: Siberry GK, Iannone R eds. The Harriet Lane Handbook: A Manual for the Pediatrician. 2000: 864.
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| * Indraccolo U, Gentile G, Pomili G, et al: Thiamine deficiency and beriberi features in a patient with hyperemesis gravidarum. Nutrition 2005 Sep; 21(9):967-8
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| * [http://www.ennonline.net/fex/01/fa18.html Diagnosing Beriberi in Emergency Situations], by Prof Mike Golden, Aberdeen University. (n.d.)
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1935533 Eric R. Gubbay. Beri-Beri Heart Disease]. Canadian Medical Association Journal. 1966 July 2; 95(1): 21–27.
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1036938 A Hardy Beriberi, vitamin B1 and world food policy, 1925-1970]. Medical History. 1995 January; 39(1): 61–77.
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| * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1798841 Neil McIntyre and Nigel N. Stanley. Cardiac Beriberi: Two Modes of Presentation]. British Medical Journal. 1971 September 4; 3(5774): 567–569.
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| * Jew RK, Mascarenhas M, McCoy B et al, eds: The Children's Hospital of Philadelphia Pharmacy Handbook and Formulary 2000-2001. Lexi-Comp Inc; 2000: 342-3.
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| * Kitamura K, Yamaguchi T, Tanaka H, et al: TPN-induced fulminant beriberi: a report on our experience and a review of the literature. Surg Today 1996; 26(10): 769-76
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| * Mouly S, Khuong MA, Cabie A: Beri-Beri and thiamine deficiency in HIV infection [letter]. AIDS 1996 Jul; 10(8): 931-2
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| * NAS: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington DC, National Academy Press; 1998.
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| * Shivalkar B, Engelmann I, Carp L: Shoshin syndrome: two case reports representing opposite ends of the same disease spectrum. Acta Cardiol 1998; 53(4): 195-9
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| * [http://www.haitianalysis.com/health Jeb Sprague and Eunida Alexandra. Haiti: Mysterious Prison Ailment Traced to U.S. Rice] - Inter Press Service (IPS). 17 January 2007.
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| * Tanphaichitr V: Thiamin. In: Shils M, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. Vol 1. 8th ed. 1994: 359-365.
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| * Weise Prinzo Z, de Benoist B: Meeting the challenges of micronutrient deficiencies in emergency- affected populations. Proc Nutr Soc 2002 May; 61(2):251-7
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| * Wilson JD: Vitamin Deficiency and Excess. In: Wilson JD, et al. Harrison's Principles of Internal Medicine. 12th ed. 1991: 436-437.
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| * Wrenn KD, Murphy F, Slovis CM: A toxicity study of parenteral thiamine hydrochloride. Ann Emerg Med 1989 Aug; 18(8): 867-70
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| {{refend}}
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| ==External links==
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| *[http://www.wrongdiagnosis.com/b/beriberi/symptoms.htm www.wrongdiagnosis.com : beriberi]
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| ==See also==
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| * [[Christiaan Eijkman]] | | * [[Christiaan Eijkman]] |
| * [[Edward Bright Vedder]] | | * [[Edward Bright Vedder]] |
| | * [[wet beriberi|Wet Beriberi]] |
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| {{Nutritional pathology}} | | {{Nutritional pathology}} |
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| [[Category:Malnutrition]]
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| [[Category:Reduplicants]]
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| [[Category:Gastroenterology]]
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| [[Category:Cardiology]]
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| [[ar:بري بري]] | | [[ar:بري بري]] |
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| [[uk:Бері-бері]] | | [[uk:Бері-бері]] |
| [[zh:脚气病]] | | [[zh:脚气病]] |
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