Thiamine Deficiency

Epidemiology

Prevalence

  • Prevalence of Thiamine Deficiency in Patients with Stable Outpatients with Congestive Heart Failure
    • Prevalence of Thiamine Deficiency is Very Low in Stable Outpatients with Congestive Heart Failure (Clin Nutr, 2016) [MEDLINE]

Physiology

Refeeding Syndrome May Exacerbate Thiamine Deficiency (see Refeeding Syndrome, Refeeding Syndrome)

  • xxxx

Diagnosis

  • xxx

Clinical Manifestations

Infantile Beriberi

Epidemiology

  • Occurs in Infants: usually manifests between 2-3 mo of age
  • Mainly Affects Infants Who are Breastfed by Mothers with a Thiamine-Deficient Diet

Clinical Manifestations

Dry Beriberi

Epidemiology

Clinical Manifestations

Wet Beriberi

Epidemiology

Clinical Manifestations

Wernicke-Korsakoff Syndrome

Epidemiology

Clinical Manifestations

  • Wernicke’s Encephalopathy
    • General Comments
      • Acute Neurologic Emergency
      • Occurs Mainly in Alcoholics with Thiamine Deficiency
      • May Be Due to Impaired Synthesis of the Pentose Phosphate Pathway Enzyme, Erythrocyte Transketolase
    • Ataxia (see Ataxia, [[Ataxia])
    • Confusion (see Delirium, Delirium)
    • Nystagmus (see Nystagmus, Nystagmus)
  • Korsakoff Syndrome
    • General Comments
      • Chronic Neurologic Syndrome Which Usually Occurs After Wernicke’s Encephalopathy
    • Confabulation
    • Deficits in Short-Term Memory (see Memory Loss, Memory Loss)
    • Grossly Normal Cognition

Treatment

Thiamine (see Thiamine, Thiamine)

  • Critical Illness
    • High-Dose Thiamine: 5-30 mg TID x several days, followed by oral thiamine 5-30 mg/day
  • Wernicke’s Encephalopathy
    • Dextrose: give first
    • High-Dose Thiamine: xxx

References

  • Wernicke encephalopathy and beriberi during total parenteral nutrition attributable to multivitamin infusion shortage. Pediatrics. 1998;101(1):E10 [MEDLINE]
  • Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg. 2008;248(5):714 [MEDLINE]
  • Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15. Epub 2009 May 13 [MEDLINE]
  • Nutrient deficiencies after gastric bypass surgery. Annu Rev Nutr. 2013;33:183-203. Epub 2013 Apr 29 [MEDLINE]
  • Prevalence of thiamine deficiency in a stable heart failure outpatient cohort on standard loop diuretic therapy. Clin Nutr. 2016;35(6):1323 [MEDLINE]