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Updated: Sep 20, 2026

Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
[Shoshin beriberi provoked by the inhalation of salbutamol]
J H Groeneveld1, P H Geelhoed-Duijvestijn, R F Veldkamp
1Afd. Interne Geneeskunde, Medisch Centrum Haaglanden, locatie Westeinde, Postbus 432, 2501 CK Den Haag.
Abstract:
A 45-year-old male alcoholic with a deficient diet was given salbutamol for exertion-related dyspnoea. After inhalation, he presented with a severe dyspnoea, acrocyanosis, anuria and low blood pressure as well as a respiratory compensated lactate acidosis. Shoshin beriberi was suspected on clinical grounds. The low level of thiamine and the prompt recovery after thiamine repletion confirmed this diagnosis. Shoshin beriberi is an acute, cardiac form of beriberi, which can rapidly result in death due to cardiogenic shock and lactate acidosis. Adrenergic agents can cause a hyperdynamic circulation and thus aggravate the effects of a thiamine deficiency.
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