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Beriberi
 
  • Beriberi occurs as a result of a thiamine deficiency and can be classed as wet, dry or infantile beriberi.
  • Each type of Beriberi has different clinical manifestations. If not treated in infants, it can be prove fatal.
  • Beriberi is easily treated and prevented by a diet rich in thiamine or by taking thiamine supplements.

Beriberi is a disease which is caused by a deficiency of vitamin B1 (thiamine). The thiamine deficiency affects the functions of the nervous system since it is involved in the metabolism of glucose and is also present in the membranes of the neurons.

Prevalence and Course
 

Beriberi is usually found in developing countries and accounts for 30% of patients worldwide. The course is usually slow and of a long duration since with the passage of time the symptoms of a vitamin B1 deficiency arise.

Causes of Beriberi

 

Beriberi is rare today due to our diets being enriched with thiamine. It is commonly encountered in people who drink large amounts of alcohol. Drinking too much alcohol can cause poor nutrition, as it becomes difficult for the body to absorb and store this essential vitamin. It also occurs in those people who eat only polished white rice or raw fish.

Description

 

Beriberi is further classified into different types; all show different types of disease manifestations:

Wet Beriberi: It mainly affects the heart and blood vessels; different organs may however also be affected too. It is characterized by decreased peripheral resistance of the vessels and an enhanced flow of blood round the body with more speed than normal. This results in increased output to the heart which is unable to maintain the increased volume of blood thus leading to heart failure.

Dry Beriberi: Here a thiamine deficiency affects the nervous system (both central and peripheral nervous system). Muscles are wasted and become weak. A number of motor and sensory manifestation take place.

Infantile beriberi: Is a disease occurring in children in developing countries. It mostly occurs in breast fed babies between the ages of 1 and 3 months.

Wernicke-Korsakoff Syndrome: Is characterized by alcohol abuse and thiamine deficiency and manifests itself via visual changes, ataxia and an impairment of memory.

Signs and Symptoms of Beriberi

 

In cases of wet beriberi, the following signs and symptoms arise:

  • A shortness of breath at night
  • Elevated heart rate
  • Edema
  • Dyspnoea on exertion
  • Leg swelling due to edema

In case of dry beriberi, the following signs and symptoms are seen:

  • Walking difficulties
  • Feeling of needles and pins
  • Tingling
  • Mental confusion
  • Numbness
  • Difficult speech
  • Paralysis of muscles particularly of the leg

The symptoms for infantile beriberi include a continuous cry; with no tears.

When to See a Doctor

 

If you experience any of these signs and symptoms, consult your doctor for further investigation as well as for treatment options.

Diagnosing Beriberi

 

Diagnosis is made via physical and neurological examination and also by the use of lab tests. Blood tests are usually recommended which measure the level of thiamine in the blood and the depressed function of the thiamine dependent enzyme, transketolase.

Treatment of Beriberi

 

Treating beriberi is achieved by the administration of thiamine supplements. A drug or injection of thiamine hydrochloride is also necessary.

Risk Factors

 
  • Patient on dialysis
  • Breast fed infants of mothers who are low in thiamine
  • Patients taking high doses of diuretics
  • Areas affected by famine
  • Exclusively raw fish diets
  • An exclusively polished white rice diet

Prevention of Beriberi

 

Beriberi can be prevented easily and simply by eating foods enriched with thiamine. These foods include whole wheat bread, unhusked rice, milk and its by-products, nuts, pork, legumes and chicken.

 
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