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Elevated Lactate Secondary to Gastrointestinal Beriberi.

James Duca1, Corey J Lum2, Angela M Lo3

  • 1John A. Burns School of Medicine, 651 Ilalo St., Honolulu, 96813, HI, USA.

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PubMed
Summary

Thiamine deficiency, a rare cause of elevated lactate and GI issues, was identified in a patient with severe symptoms. Prompt thiamine treatment rapidly resolved the condition, highlighting its importance in diagnosis.

Keywords:
Elevated lactateGastrointestinal beriberiMorbidityPhrases to use in indexingThiamine deficiencyThiamine malabsorption

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Area of Science:

  • Biochemistry
  • Neurology
  • Gastroenterology

Background:

  • Thiamine deficiency is commonly linked to Wernicke's encephalopathy or beriberi.
  • It can, however, present atypically with elevated lactate and gastrointestinal symptoms.

Observation:

  • A 30-year-old male presented with a two-week history of gastroenterological issues and intermittent oral intake.
  • Elevated lactate levels were detected, but neurological examination was normal, and extensive workup yielded no other significant findings.

Findings:

  • The patient's lactate level normalized overnight, and all symptoms resolved following thiamine administration.
  • Subsequent laboratory tests confirmed low thiamine levels (44 nmol/L), below the normal range of 78-185 nmol/L.

Implications:

  • Recognizing thiamine deficiency as a cause of elevated lactate and GI symptoms is crucial.
  • Timely diagnosis and treatment can prevent unnecessary investigations, reduce patient morbidity, and potentially avoid mortality.