Beriberi differential diagnosis: Difference between revisions
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{{Beriberi}} | {{Beriberi}} | ||
{{CMG}}; {{AE}}{{AIA}} | {{CMG}}; {{AE}}{{AIA}} | ||
==Overview== | ==Overview== | ||
Beriberi should be differentiated from other causes of cardiac dysfunction (wet beriberi), peripheral neuropathy (dry beriberi), delirium (Wernicke-Korsakoff syndrome) andexcessive alcohol drinking. However, the differential diagnosis is broad due to the non-specific symptoms of cardiac and neural involvement associated with the condition. | |||
==Differentiating Beriberi from other Diseases== | |||
Beriberi should be differentiated from other causes of cardiac dysfunction (wet beriberi), peripheral neuropathy (dry beriberi), delirium (WKS), and other disorders caused by excessive alcohol drinking. However, the differential diagnosis is broad due to the non-specific symptoms of cardiac and neural involvement associated with beriberi.<ref name="pmid30151974">{{cite journal| author=Whitfield KC, Bourassa MW, Adamolekun B, Bergeron G, Bettendorff L, Brown KH et al.| title=Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. | journal=Ann N Y Acad Sci | year= 2018 | volume= 1430 | issue= 1 | pages= 3-43 | pmid=30151974 | doi=10.1111/nyas.13919 | pmc=6392124 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30151974 }}</ref><ref name="pmid29360523">{{cite journal| author=DiNicolantonio JJ, Liu J, O'Keefe JH| title=Thiamine and Cardiovascular Disease: A Literature Review. | journal=Prog Cardiovasc Dis | year= 2018 | volume= 61 | issue= 1 | pages= 27-32 | pmid=29360523 | doi=10.1016/j.pcad.2018.01.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29360523 }}</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> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
!Disorders | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disorders | ||
!Etiology | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Etiology | ||
!Clinical Presentation | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical Presentation | ||
!Laboratory findings | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Laboratory findings | ||
|- | |- | ||
!Cardiomyopathy due to other causes as alcohol or DM | |||
| | | | ||
* Idiopathic | * Idiopathic | ||
* Alcoholic cardiomyopathy | * Alcoholic cardiomyopathy | ||
* Diabetic cardiomyopathy | *[[Diabetic cardiomyopathy]] | ||
* Infections: HIV, Coxsackie | * Infections: HIV, [[Coxsackie virus|Coxsackie]] | ||
| | | | ||
* Dyspnea/Orthopnea | |||
* Edema | |||
*[[Syncope]] | |||
* Palpitations | |||
| | | | ||
*[[Hyponatremia]] | |||
* Elevated [[brain natriuretic peptide]] | |||
* Elevated [[troponin]] (in ischemia) | |||
|- | |- | ||
!Delirium and delusional disorders | |||
| | | | ||
* [[Acute liver failure]] | |||
* Acute metabolic and electrolyte disturbances | |||
* Infections/sepsis | |||
* Toxins/drug overdose | |||
| | | | ||
* Disturbed attention | |||
* Poor cognition | |||
* Impaired psychomotor activity | |||
* Emotional instability | |||
| | | | ||
* [[Arterial blood gas|Arterial blood gases]] | |||
* CBC: [[Leukocytosis|Leucocytosis]] | |||
* [[Blood culture]] | |||
* Glucose and electrolyte levels | |||
|- | |- | ||
!Nerve entrapment disorders | |||
|Chronic injuries to nerves as they pass between bones and ligaments: | |Chronic injuries to nerves as they pass between bones and ligaments: | ||
* Carpal tunnel syndrome | *[[Carpal tunnel syndrome]] | ||
* Cubital tunnel syndrome | * Cubital tunnel syndrome | ||
* Suprascapular nerve compression | * Suprascapular nerve compression | ||
| Line 39: | Line 57: | ||
|Within the distribution of the affected nerve, the patient may complain of: | |Within the distribution of the affected nerve, the patient may complain of: | ||
* [[Paresthesia|Parasthesia]] | *[[Paresthesia|Parasthesia]] | ||
* Sensory loss | * Sensory loss | ||
* Pain | * Pain | ||
* [[Muscle weakness]] | *[[Muscle weakness]] | ||
* [[Muscle atrophy]] | *[[Muscle atrophy]] | ||
* | * | ||
| Line 49: | Line 67: | ||
* MRI short inversion imaging recovery (STIR) technique | * MRI short inversion imaging recovery (STIR) technique | ||
|- | |- | ||
!Alcoholic hepatitis | |||
| | | | ||
* Chronic and excessive alcohol consumption | * Chronic and excessive alcohol consumption | ||
| Line 60: | Line 78: | ||
| | | | ||
* Increased serum levels of ALT and AST | * Increased serum levels of ALT and AST | ||
* Blood picture: Leukemoid reactions (high WBCs count) may be present. | * Blood picture: [[Leukemoid reaction|Leukemoid reactions]] (high WBCs count) may be present. | ||
* Liver US: Changes in liver size and dilatation of hepatic veins. | * Liver US: Changes in liver size and dilatation of hepatic veins. | ||
|- | |- | ||
!Diabetic ketoacidosis | |||
|In patients with type 1 DM, exposed to: | |In patients with type 1 DM, exposed to: | ||
* Poor insulin compliance | * Poor insulin compliance | ||
* Infections/sepsis | * Infections/[[sepsis]] | ||
* Stress | * Stress | ||
* Idiopathic | * Idiopathic | ||
| | | | ||
* Early: [[Polydipsia]] and [[polyuria]] | * Early: [[Polydipsia]] and [[polyuria]] | ||
* [[Anorexia]] | *[[Anorexia]] | ||
* Nausea and vomiting | * Nausea and vomiting | ||
* Abdominal tenderness | * Abdominal tenderness | ||
* Late: Disturbed consciousness | * Late: Disturbed consciousness | ||
| | | | ||
* Hyperglycemia | *[[Hyperglycemia]] | ||
* Lower PH and bicarbonate levels | * Lower PH and bicarbonate levels | ||
* Ketonemia and ketonuria | * Ketonemia and [[ketonuria]] | ||
* Electrolyte disturbances | * Electrolyte disturbances | ||
* Impaired renal function | * Impaired renal function | ||
|- | |- | ||
!Hyperthyroidism | |||
| | | | ||
* Primary: Grave's disease, toxic thyroid nodules and adenoma | * Primary: [[Graves' disease|Grave's disease]], toxic thyroid nodules and adenoma | ||
* Secondary: Pituitary | * Secondary: [[Pituitary adenoma]]<nowiki/>s and intracranial tumors | ||
* Tertiary:Intracranial tumors involving the hypothalamus | * Tertiary:Intracranial tumors involving the [[hypothalamus]] | ||
| | | | ||
* [[Goiter]] | *[[Goiter]] | ||
* [[Palpitations]] | *[[Palpitations]] | ||
* [[Anxiety]] | *[[Anxiety]] | ||
* Heat intolerance | * Heat intolerance | ||
* [[Insomnia]] | *[[Insomnia]] | ||
* [[Weight loss]] | *[[Weight loss]] | ||
* [[Diarrhea]] | *[[Diarrhea]] | ||
* [[Exophthalmos|Exophthalmus]] | *[[Exophthalmos|Exophthalmus]] | ||
| | | | ||
* Elevated T3 and T4 hormones | * Elevated T3 and T4 hormones | ||
* TSH: Reduced in 1ry and Elevated in 2ry hyperthyroidism. | *[[Thyroid-stimulating hormone|TSH]]: Reduced in 1ry and Elevated in 2ry hyperthyroidism. | ||
* Thyroid stimulating antibodies: Elevated only in Grave's disease | * Thyroid stimulating antibodies: Elevated only in Grave's disease | ||
|- | |- | ||
!Folic acid deficiency | |||
| | | | ||
* [[Malnutrition]] | *[[Malnutrition]] | ||
* Intestinal bacterial overgrowth | * Intestinal bacterial overgrowth | ||
* [[Celiac disease|Celiac]] disease | *[[Celiac disease|Celiac]] disease | ||
* [[Blind loop syndrome]] | *[[Blind loop syndrome]] | ||
* [[Inflammatory bowel disease]] | *[[Inflammatory bowel disease]] | ||
* Pregnancy | * Pregnancy | ||
* Vegetarians | * Vegetarians | ||
| Line 119: | Line 137: | ||
| | | | ||
* Low serum folate <2.5ng/ml | * Low serum folate <2.5ng/ml | ||
* CBC: Macrocytic anemia and low correlated reticulocyte count | * CBC: [[Macrocytic anemia]] and low correlated reticulocyte count | ||
* Peripheral blood smear: Neutrophil granulocytes and anisocytosis | * Peripheral blood smear: Neutrophil granulocytes and [[anisocytosis]] | ||
|} | |} | ||
Latest revision as of 20:02, 24 January 2020
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Beriberi Microchapters |
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Beriberi differential diagnosis On the Web |
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Risk calculators and risk factors for Beriberi differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]
Overview
Beriberi should be differentiated from other causes of cardiac dysfunction (wet beriberi), peripheral neuropathy (dry beriberi), delirium (Wernicke-Korsakoff syndrome) andexcessive alcohol drinking. However, the differential diagnosis is broad due to the non-specific symptoms of cardiac and neural involvement associated with the condition.
Differentiating Beriberi from other Diseases
Beriberi should be differentiated from other causes of cardiac dysfunction (wet beriberi), peripheral neuropathy (dry beriberi), delirium (WKS), and other disorders caused by excessive alcohol drinking. However, the differential diagnosis is broad due to the non-specific symptoms of cardiac and neural involvement associated with beriberi.[1][2][3]
| Disorders | Etiology | Clinical Presentation | Laboratory findings |
|---|---|---|---|
| Cardiomyopathy due to other causes as alcohol or DM |
|
|
|
| Delirium and delusional disorders |
|
|
|
| Nerve entrapment disorders | Chronic injuries to nerves as they pass between bones and ligaments:
|
Within the distribution of the affected nerve, the patient may complain of:
|
|
| Alcoholic hepatitis |
|
|
|
| Diabetic ketoacidosis | In patients with type 1 DM, exposed to:
|
|
|
| Hyperthyroidism |
|
|
|
| Folic acid deficiency |
|
|
|
References
- ↑ Whitfield KC, Bourassa MW, Adamolekun B, Bergeron G, Bettendorff L, Brown KH; et al. (2018). "Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs". Ann N Y Acad Sci. 1430 (1): 3–43. doi:10.1111/nyas.13919. PMC 6392124. PMID 30151974.
- ↑ DiNicolantonio JJ, Liu J, O'Keefe JH (2018). "Thiamine and Cardiovascular Disease: A Literature Review". Prog Cardiovasc Dis. 61 (1): 27–32. doi:10.1016/j.pcad.2018.01.009. PMID 29360523.
- ↑ 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.