Journal Article

Cardiac Beriberi: Often a Missed Diagnosis

S. Narasimha Rao and G. R. Chandak

in Journal of Tropical Pediatrics

Volume 56, issue 4, pages 284-285
Published in print August 2010 | ISSN: 0142-6338
Published online November 2009 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmp108
Cardiac Beriberi: Often a Missed Diagnosis

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Thiamine deficiency leads to various manifestations due to dysfunction of nervous or cardiovascular system, commonly known as dry and wet beriberi, respectively. The latter, also known as cardiac beriberi is usually missed in clinical practice because of the absence of classically described symptoms such as pedal edema/anasarca. We investigated 55 such infants and prospectively followed their clinical course. All the babies were exclusively breast-fed and their mothers belonged to low socio-economic status with their staple diet consisting of non-parboiled polished rice. Majority presented with tachypnea, chest indrawing and tachycardia and cardiomegaly with dilatation of right heart and pulmonary hypertension on 2D-echocardiography. Low levels of erythrocyte transketolase activity suggested thiamine deficiency that was confirmed by reversion of several clinical features including cardiologic abnormalities to normalcy on thiamine supplementation. We recommend thiamine therapy for infants with unexplained congestive cardiac failure or acute respiratory failure from precarious socio-economic background since it is life-saving in many instances.

Keywords: thiamine deficiency; nutrition–infant; cardiac beriberi; right heart failure; public health

Journal Article.  722 words. 

Subjects: Paediatrics

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