ABSTRACT
A deficiência de tiamina pode apresentar quatro formas clássicas de apresentação clínica: polineuropatia periférica, anorexia e fraqueza muscular (beribéri seco); insuficiência cardíaca de alto débito com sinais congestivos (beribéri úmido); beribéri associado ao choque (Shoshin beribéri) e encefalopatia de Wernicke. Neste relato, descrevemos quadro sugestivo de hipertensão pulmonar grave e cor pulmonale, com estase jugular, hepatite congestiva e edema generalizado, que apresentou reversão completa após administração de tiamina.
Thiamine deficiency may present four classic clinical forms: peripheral polyneuropathy, anorexia and muscular weakness (dry beriberi); high output heart failure with signs of congestion (wet beriberi); beriberi associated with shock (Shoshin beriberi) and Wernicke's encephalopathy. In this report we describe a picture that is suggestive of severe pulmonary hypertension and cor pulmonale, with jugular stasis, congestive hepatitis and generalized edema that reversed completely after the administration of thiamine.
Subject(s)
Adult , Humans , Male , Beriberi/complications , Hypertension, Pulmonary/etiology , Pulmonary Heart Disease/etiology , Thiamine/therapeutic use , Beriberi/drug therapy , Pulmonary Heart Disease/drug therapy , Thiamine Deficiency/complications , Thiamine Deficiency/drug therapy , Vitamin B Complex/therapeutic useABSTRACT
Tachycardia as a presenting symptom and part of Wernicke's encephalopathy was detected in a patient who was having a discharging fistula from the small bowel for which he received total parenteral nutrition for approximately five weeks. Thiamine deficiency is known to occur during total parenteral nutrition and this case report describes the evolution of the cardiac and neurological manifestations of this disorder