Beriberi history and symptoms: Difference between revisions
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==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 | *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. | ||
*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]]. | *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]]. | ||
Revision as of 14:30, 12 November 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
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.
- 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.
- 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.
- 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 alcoholics 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.
- 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.
- Psychotic beriberi: Psychotic beriberi manifesting with auditory and visual hallucinations, odd and aggressive behavior has been recently described in gastric bypass patients.