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[Diuretics-induced beriberi polyneuropathy: a case report].

Daisuke Kuzume¹, Yusuke Inoue^1,2, Yuko Morimoto¹

¹Department of Neurology, Chikamori Hospital.

Rinsho Shinkeigaku = Clinical Neurology

|July 24, 2022

Summary

Diuretic use can lead to vitamin B1 deficiency, causing beriberi neuropathy and muscle weakness. Prompt thiamine treatment rapidly improved symptoms in a heart failure patient.

Keywords:

beriberi neuropathy diuretic heart failure

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Area of Science:

Neurology
Nutritional Science
Cardiology

Background:

Heart failure management often involves diuretics, which can deplete essential nutrients.
An unbalanced diet, particularly low in thiamine (vitamin B1), increases risk.
Beriberi neuropathy presents with neurological deficits, including muscle weakness.

Observation:

A 56-year-old man on diuretics for heart failure developed progressive bilateral lower extremity weakness.
Physical examination revealed altered consciousness, edema, weakness, and areflexia.
Laboratory tests showed a low vitamin B1 level (12 ng/ml).

Findings:

The patient was diagnosed with diuretic-induced beriberi neuropathy.
Thiamine supplementation led to rapid improvement in neurological symptoms.
Diuretics are known to increase urinary excretion of vitamin B1.

Implications:

This case highlights the importance of considering vitamin B1 deficiency in patients with unexplained neurological symptoms during diuretic therapy.
Neurologists and cardiologists should monitor vitamin B1 levels in at-risk patients.
Supplementation with thiamine may prevent or treat beriberi neuropathy in this context.