Beriberi classification: Difference between revisions
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==Classification== | ==Classification== | ||
Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. | Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. | ||
Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations. | |||
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|Wet beriberi | |Wet beriberi | ||
|Cardiovascular System | |Cardiovascular System | ||
| | | | ||
* Acute fulminant/pernicious form (Shoshin beriberi): This form is characterized by rapid onset, progressive disease course, and poor prognosis (often fatal). | |||
* Chronic wet beriberi: This form has a subtle onset and a gradual course and usually ends in high-output heart failure. | |||
|Individuals with chronic thiamine deficiency | |||
| | |||
* Heart failure (acute or chronic). | |||
* Peripheral edema: due to weakened capillary beds in peripheral tissues leading to fluid leakage. | |||
|- | |- | ||
|Dry beriberi | |Dry beriberi | ||
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|Usually follows a progressive disease course and has three distinct forms: | |Usually follows a progressive disease course and has three distinct forms: | ||
* Cardiac or pernicious: Rapid onset, progressive course, and poor prognosis. | |||
* Aphonic form: Subtle onset and a mild course. | |||
* Pseudomeningitic form: Progressive course. | |||
|Infants nursed by thiamine-deficient mothers. | |Infants nursed by thiamine-deficient mothers. | ||
* Cardiac: 1 to 3 months of old. | |||
* Aphonic:4 to 6 months old. | |||
* Pseudomeningitic: 7 to 9 months old. | |||
|Early signs include restlessness, constipation, and vomiting. | |||
* Cardiac form: Acute cardiac failure (edema and cyanosis). Once heart failure develops, the infant may die in two to four hours. | |||
* Aphonic form: hoarseness, weak cry, and even loss of voice due to vocal cord paralysis. | |||
* Pseudomeningitic form: The classic presentation of meningitis (nystagmus, vomiting and seizures); however, CSF analysis reveals no infectious organisms. | |||
|- | |- | ||
|Wenicke-Korsakoff Syndrome | |Wenicke-Korsakoff Syndrome | ||
|Brain | |Brain | ||
|Two conditions: Acute (Wernicke's encephalopathy) or | |Two conditions: | ||
* Acute (Wernicke's encephalopathy) or | |||
* Chronic (Korsakoff psychosis) | |||
|Chronic alcoholics (precipitated by high carbohydrate consumption that exacerbates subclinical thiamine deficiency) | |Chronic alcoholics (precipitated by high carbohydrate consumption that exacerbates subclinical thiamine deficiency) | ||
| | | | ||
* Wernicke's encephalopathy: Confusion, ataxia, ptosis, and double vision. | |||
* Korsakoff psychosis: Hallucinations, confabulation, and amnesia. | |||
|}<br /> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 18:39, 5 November 2019
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Overview
Classification
Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations.
Affected Site | Course | Population | Presentation | |
---|---|---|---|---|
Wet beriberi | Cardiovascular System |
|
Individuals with chronic thiamine deficiency |
|
Dry beriberi | Peripheral nervous system | Usually follows a chronic disease course | Individuals with chronic thiamine deficiency | Polyneuritis and symmetric, ascending paralysis of the peripheral nerve systems. It first affects the sensory system (parasthesia), then the motor system (loss of tendon reflexes, followed by foot and wrist drop) |
Infantile beriberi | Cardiovascular or nervous system | Usually follows a progressive disease course and has three distinct forms:
|
Infants nursed by thiamine-deficient mothers.
|
Early signs include restlessness, constipation, and vomiting.
|
Wenicke-Korsakoff Syndrome | Brain | Two conditions:
|
Chronic alcoholics (precipitated by high carbohydrate consumption that exacerbates subclinical thiamine deficiency) |
|