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Non-specific hyperamylasemia in shosin beri-beri
Souichi Maekawa1, Mayuki Aibiki, Junsuke Hinami
1Department of Emergency Medicine, Ehime University, Shitsukawa 454, Shigenobu, Onsen, 791-0295 Ehime, Japan.
Resuscitation
|August 12, 2003
Summary
This case report details non-specific hyperamylasemia in a patient with cardiovascular beri-beri. Thiamine administration successfully treated the condition, highlighting a new cause for elevated amylase levels.
Area of Science:
- Cardiology
- Endocrinology
- Gastroenterology
Background:
- Non-specific hyperamylasemia is typically associated with conditions like cardiac surgery and diabetic ketoacidosis.
- Cardiovascular beri-beri, a severe thiamine deficiency, can present with shock and metabolic acidosis.
Observation:
- A patient presented with shock, severe metabolic acidosis, and non-specific hyperamylasemia.
- Echocardiography showed hyperkinetic wall motion of the left ventricle.
- Abdominal CT ruled out acute pancreatitis.
Findings:
- The patient's history suggested cardiovascular beri-beri secondary to chronic alcoholism.
- Thiamine administration led to dramatic reversal of hemodynamic instability, metabolic acidosis, and abdominal pain.
- Isozyme analysis revealed predominantly salivary-type amylase in serum.
Implications:
- This case expands the known causes of non-specific hyperamylasemia in emergency settings.
- It underscores the importance of considering thiamine deficiency in patients with unexplained hyperamylasemia and shock.
- Early diagnosis and thiamine treatment are crucial for managing cardiovascular beri-beri.