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Acute pernicious or fulminating beriberi heart disease. A report of 6 patients
J C ter Maaten1, S J Hoorntje, H F Hillen
1Department of Internal Medicine, Catharina Hospital, Eindhoven, Netherlands.
Objective:
To investigate the incidence and presentation of acute pernicious or fulminating beriberi in a general district hospital.
Methods:
All patients with a diagnosis of acute pernicious or fulminating beriberi heart disease made between 1978 and 1994 were identified, and their medical records were retrospectively examined.
Results:
Six cases of acute pernicious or fulminating beriberi heart disease were recognized. The disease was characterized by circulatory shock and peripheral cyanosis. All patients had severe lactic acidosis, in 5 of them without hypoxaemia. Four patients were alcoholics. The most important diagnostic criterion was the impressive improvement after thiamine administration.
Conclusions:
Acute pernicious or fulminating beriberi heart disease can be recognized occasionally. Thiamine should be administered as soon as possible in suspected cases.