Beriberi
Alerts and Notices
Synopsis

- Infantile beriberi – Secondary to thiamine-deficient mothers exclusively breastfeeding or absence of thiamine in formula.
- Adult beriberi, dry – Characterized by symmetrical distal extremity peripheral neuropathy.
- Adult beriberi, wet – Characterized by dilated cardiomyopathy and peripheral edema.
- Shoshin beriberi – Fulminant wet beriberi characterized by cardiogenic shock, lactic acidosis, and multiple organ failure.
- Alcohol amnestic disorder – Wernicke encephalopathy is a triad of nystagmus, ophthalmoplegia, and ataxia with associated confusion. It is often found in people with alcohol use disorder who have chronic thiamine deficiency.
- Leigh syndrome – A mitochondrial disorder of progressive subacute necrotizing encephalomyopathy of infancy associated with thiamine deficiency.
- Tropical ataxic neuropathy – Condition endemic to Nigeria that is characterized by polyneuropathy, gait ataxia, bilateral optic atrophy, and deafness.
Codes
ICD10CM:E51.11 – Dry beriberi
E51.12 – Wet beriberi
SNOMEDCT:
36656008 – Beriberi
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Differential for wet beriberi:- Hyperthyroidism (or thyrotoxicosis)
- Dilated cardiomyopathy secondary to diabetes, alcohol use disorder, cocaine use disorder, coxsackie B viral myocarditis, or Chagas disease
- Liver failure
- Severe anemia
- Other causes of high-output heart failure
- Diabetic peripheral neuropathy
- Uremia
- Guillain-Barré syndrome (see acute inflammatory demyelinating polyneuropathy)
- Infections – viral infection, meningitis, pneumonia, typhus, malaria
- Congenital heart defect
- Pediatric forms of the illnesses above including hyperthyroidism, cardiomyopathy, liver failure, etc
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:04/11/2019
Last Updated:05/07/2019
Last Updated:05/07/2019