Shoshin beriberi: an underdiagnosed condition?

Area of Science:

• Cardiology
• Nutritional Science
• Internal Medicine

Background:

• Beriberi, a disease caused by thiamine deficiency, classically presents with edema and neurological symptoms.
• Heart failure is a known complication of severe thiamine deficiency, but its fulminant form, Shoshin beriberi, has distinct clinical features.

Observation:

• Shoshin beriberi is characterized by a cold periphery, hypotension, renal failure, and severe metabolic acidosis.
• This fulminant presentation differs significantly from the typical beriberi heart failure.
• Two cases were observed within a short period in a general hospital setting.

Findings:

• Dietary thiamine deficiency was identified as a primary contributing factor in both observed cases.
• The true incidence of Shoshin beriberi remains unknown, suggesting potential underdiagnosis.

Implications:

• Prompt recognition of Shoshin beriberi's unique signs is essential for effective treatment.
• Increased awareness may improve diagnosis rates for this critical condition.
• Highlighting the link between dietary thiamine deficiency and severe heart failure outcomes.