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Infantile Beriberi


Presentation

  • Materials And Methods : We performed a retrospective review of head sonography of infants (admitted between November 1, 2014, and March 31, 2015) who presented with encephalopathy.[pubfacts.com]
  • We noticed 3 patterns: 1- to 2-month-old infants (16/41) presented with lactic acidosis. Infants older than 5 months of age (11/41) presented with Wernicke encephalopathy.[ajnr.org]
  • Common feature: infant breast fed by mothers with thiamine deficiency Types of presentations: (1) cardiac (2) aphonic (3) pseudomeningitic Cardiac presentation (usual onset age 1-3 months): (1) peripheral edema (2) breathlessness, cyanosis and pulmonary[meducator3.net]
  • Most of the patients presented with severe respiratory irregularities.[academic.oup.com]
  • "Early Vitamin History," presented in a humorous way, is his most favorite topic.[books.google.com]
Rigor
  • […] injection -- no information is given about subsequent doses -- retrospective chart review study 2014: 100% survival in Cambodia using a dose of 100 mg IM for 3 days -- this seems to be the purest study since the data was collected prospectively using rigorous[en-net.org]
Myxedema
  • Myxedema is a dry waxy type of swelling, often with swollen lips and nose. Infantile myxedema is also called infantile hypothyroidism.[definithing.com]
Respiratory Abnormalities
  • Within 24 h the first signs of improvement were noted in the level of consciousness, respiratory abnormalities and ptosis whereas head control, tone, involuntary movements and milestones recovered partially over next few weeks.[academic.oup.com]
Tachycardia
  • The clinical features are: anorexia oedema tachycardia tachypnoea There is a fatal outcome unless treatment is initiated rapidly. Links: treatment of infantile beriberi beriberi[gpnotebook.co.uk]
  • Abstract An infant, 5½ months of age, died after a brief acute illness characterized by irritability and somnolence leading terminally to coma, and by excessive sweating, abdominal distension, tachypnea and tachycardia.[pediatrics.aappublications.org]
  • Presenting symptoms include tachycardia, low diastolic pressure, cardiomegaly, pulmonary edema, and cyanosis. Wet beriberi is characterized by elevated lactic acid levels.[emedicine.medscape.com]
Delayed Milestone
  • In patients with developmental delay, milestones and tone were slow to recover during 4–14 weeks. Normal breastfeeding was achieved in a mean of 6 hours. The mean duration of the hospital stay was 3.25 days.[ajnr.org]
  • All 15 patients who were re-examined within 3–6 months of initial illness, were clinically normal except two who still had hypotonia, delayed milestones and persistence of brain lesions on imaging.[academic.oup.com]
Grunting
  • Additional admission information was collected for infants with clinical beriberi-these infants had lethargy (74%), poor feeding (72%), vomiting (60%), dyspnoea (81%), grunting (82%, n   45), palpable liver (96%, n   27), peripheral oedema (25%, n   44[journals.plos.org]

Workup

Hypsarrhythmia
  • Small numbers of virus enter the blood and go to other sites where the virus multiplies more […] Infantile spasms A seizure disorder of infancy and early childhood with the onset predominantly in the first year of life of myoclonic seizures, hypsarrhythmia[definithing.com]
  • Journal of the Medical Association of Thailand 70(10): 596-603, 1987 Leigh's subacute necrotizing encephalomyelopathy in a child with infantile spasms and hypsarrhythmia.[eurekamag.com]
Microalbuminuria
  • Blood Thiamine and Derivatives as measured by High-Performance Liquid Chromatography: Levels and Associations in DM Patients with Varying Degrees of Microalbuminuria. J Endocrinol Invest. 2011 Nov 22. [Medline].[medscape.com]
Thrombocytosis
  • Blood picture in infantile beriberi, infantile preberiberi and infantile B-avitaminotic dyspepsia is characterized by 1) anemia-and hypohemoglobinemia, 2) thrombocytosis, 3) neutropenia in almost all the cases, lymphocytosis and esoinophilia in soave[jstage.jst.go.jp]

Treatment

  • The clinical features are: anorexia oedema tachycardia tachypnoea There is a fatal outcome unless treatment is initiated rapidly. Links: treatment of infantile beriberi beriberi[gpnotebook.co.uk]
  • Expand your knowledge concerning rare and neglected tropical diseases, as well as how diagnosis and treatment takes place in resource-poor settings.[books.google.com]
  • Modern imaging and diagnostic strategies have facilitated the rapid treatment, and potential reversal of these clinical disorders.[books.google.com]

Prognosis

  • Although, untreated Beriberi can eventually lead to death Commencing thiamine supplementation can cause an improvement in the symptoms If congestive heart failure occurs, the prognosis is poor.[dovemed.com]
  • Prognosis The prognosis for beriberi is usually good, unless patients have established Korsakoff syndrome. When patients have progressed to this stage, the degree of damage is only minimally reversible.[namrata.co]
  • Prognosis of Beriberi The prognosis for beriberi is usually good, unless patients have established Korsakoff syndrome.  When patients have progressed to this stage, the degree of damage is only minimally reversible. 39Biochemistry for medics 40.[slideshare.net]
  • Prognosis Mortality is rare and is usually associated with the wet form due to cardiac failure. [ 26 ] Morbidity is also rare and usually presents in the dry form with neurological symptoms.[patient.info]

Etiology

  • "The cure of infantile beriberi by the administration to the infant of an extract of rice polishing, and the bearing thereof on the etiology of beriberi" Bull Manila Med Soc 6(2): 26-29, 1912 14.[herdin.ph]
  • The etiology of " moist beri-beri" has not yet been fully investigated, but there seems to be some suggestion that a relationship exists between this malady and the poor quality of the milk yielded by Filipino mothers.[kundoc.com]
  • ., vitamin B 12 deficiency in patients with diseases affecting the terminal ileum ) Etiology Maldigestion Impaired breakdown of food in the intestinal lumen Exocrine pancreatic insufficiency ; lack of enzymes reduced hydrolysis of carbohydrates , proteins[amboss.com]
  • The cure of infantile beriberi by the administration to the infant of an extract of rice polishing, and the bearing thereof on the etiology of beriberi. Bull Manila Med Soc 1912;6:26-33. Disclosure: Dr.[n.neurology.org]

Epidemiology

  • Although this is almost the exact epidemiology of modern SIDS, this well researched truth is ignored.[hormonesmatter.com]
  • In the early 20 th century there was an enormous international effort to understand the causes, epidemiology and prevention of this devastating and common disease in the rice consuming societies of Asia [1] – [9] .[journals.plos.org]
  • […] concurrently, including Wernicke's encephalopathy (mainly affecting the central nervous system), Korsakoff's syndrome (amnesia with additional psychiatric manifestations), and Wernicke-Korsakoff syndrome (with both neurologic and psychiatric symptoms) Epidemiology[flipper.diff.org]
  • Detailed epidemiologic, dietary, clinical, laboratory, and treatment data of these children had been obtained.[ajnr.org]
  • Another translation is 'I cannot, I cannot'. [ 2 ] Epidemiology Beriberi was endemic in some areas of the world and may be related to the consumption of milled rice.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of cardiac dysfunction in infantile beriberi is not understood and, as far as we are aware, there have been no echocardiographic or cathertisation studies.[journals.plos.org]
  • Pathophysiology Thiamine in the human body has a half-life of 18 days and is quickly exhausted, particularly when metabolic demands exceed intake.[flipper.diff.org]
  • This type of rice has its husk removed in order to extend its lifespan, but also has the unintended side-effect of removing the primary source of thiamine. [1] Pathophysiology Edit Thiamine has a half-life of 18 days and is quickly exhausted, particularly[psychology.wikia.com]
  • Pathophysiology of Thiamine deficiency (Beri-Beri) Deficiency causes degeneration of peripheral nerves, thalamus, mammillary bodies, and cerebellum. Cerebral blood flow is markedly reduced, and vascular resistance is increased.[namrata.co]
  • The data provide important insights on the nutritional pathophysiology of thiamine depletion, repletion, and therapeutics and a sobering reminder that nutritional deficiency disease, including beriberi, persists as an important cause of morbidity and[ajcn.nutrition.org]

Prevention

  • Rickets was common in northern cities and was more rampant in industrial cities as industrial pollution prevented children from sunlight exposure.[books.google.com]
  • “Through fortification (adding vitamins to foods eaten every day) we can prevent beriberi without asking [Cambonian women] to change a thing.[lfs-lc-collabtm.sites.olt.ubc.ca]
  • Thiamine deficiency and its prevention and control in major emergencies. WHO/NHD/99.13. pages 9 and 47.[meducator3.net]

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