Cause:Thiamine (B₁) deficiency

Pathophys:Unknown function of thiamine; increased requirement when eat or give glucose; in decarboxylation of pyruvate to citric acid cycle; CHF may be due to high cardiac output failure from neuropathic poor vascular tone

Sx:

Wet beriberi: Edema

Dry beriberi: "Burning" feet

Infantile beriberi: Nausea and vomiting; dyspnea

Si:

Wet beriberi: Edema, elevated CVP

Dry beriberi: Peripheral neuropathy

Infantile beriberi: Cyanosis, tachycardia, seizures, hypotension

All improve w po or parenteral thiamine

Wernicke's encephalopathy

Wet beriberi: High-output CHF and pulmonary edema

Dry beriberi: Phrenic nerve involvement

Infantile beriberi: CHF and pulmonary edema

Rx:Thiamine 100 mg po or im qd