Beriberi classification: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. | Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. Other forms as infantile beriberi or [[Wernicke-Korsakoff syndrome]] occur in special populations. | ||
Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations. | |||
==Classification== | ==Classification== | ||
Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. | |||
Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations.<ref name="pmid8868953">{{cite journal| author=Meurin P| title=[Shoshin beriberi. A rapidly curable hemodynamic disaster]. | journal=Presse Med | year= 1996 | volume= 25 | issue= 24 | pages= 1115-8 | pmid=8868953 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8868953 }}</ref><ref name="pmid30725889">{{cite journal| author=| title=StatPearls | journal= | year= 2019 | volume= | issue= | pages= | pmid=30725889 | doi= | pmc= | url= }}</ref><ref name="pmid31171116">{{cite journal| author=Sinha S, Kataria A, Kolla BP, Thusius N, Loukianova LL| title=Wernicke Encephalopathy-Clinical Pearls. | journal=Mayo Clin Proc | year= 2019 | volume= 94 | issue= 6 | pages= 1065-1072 | pmid=31171116 | doi=10.1016/j.mayocp.2019.02.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31171116 }}</ref><ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH et al.| title=2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= 62 | issue= 16 | pages= e147-239 | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642 }}</ref><ref name="pmid18948797">{{cite journal| author=Aasheim ET| title=Wernicke encephalopathy after bariatric surgery: a systematic review. | journal=Ann Surg | year= 2008 | volume= 248 | issue= 5 | pages= 714-20 | pmid=18948797 | doi=10.1097/SLA.0b013e3181884308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18948797 }}</ref> | * Beriberi is usually classified into two types based on the main system affected (Wet and dry). | ||
* The two forms may appear in the same patient, but one form dominates the disease phenotype. | |||
* Other forms as infantile beriberi or [[Wernicke-Korsakoff syndrome]] occur in special populations.<ref name="pmid8868953">{{cite journal| author=Meurin P| title=[Shoshin beriberi. A rapidly curable hemodynamic disaster]. | journal=Presse Med | year= 1996 | volume= 25 | issue= 24 | pages= 1115-8 | pmid=8868953 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8868953 }}</ref><ref name="pmid30725889">{{cite journal| author=| title=StatPearls | journal= | year= 2019 | volume= | issue= | pages= | pmid=30725889 | doi= | pmc= | url= }}</ref><ref name="pmid31171116">{{cite journal| author=Sinha S, Kataria A, Kolla BP, Thusius N, Loukianova LL| title=Wernicke Encephalopathy-Clinical Pearls. | journal=Mayo Clin Proc | year= 2019 | volume= 94 | issue= 6 | pages= 1065-1072 | pmid=31171116 | doi=10.1016/j.mayocp.2019.02.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31171116 }}</ref><ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH et al.| title=2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= 62 | issue= 16 | pages= e147-239 | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642 }}</ref><ref name="pmid18948797">{{cite journal| author=Aasheim ET| title=Wernicke encephalopathy after bariatric surgery: a systematic review. | journal=Ann Surg | year= 2008 | volume= 248 | issue= 5 | pages= 714-20 | pmid=18948797 | doi=10.1097/SLA.0b013e3181884308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18948797 }}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
| Line 19: | Line 21: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Presentation | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Presentation | ||
|- | |- | ||
! rowspan="2" |Classification based on main organ-system affected | |||
!Wet beriberi | |||
!Cardiovascular System | |||
| | | | ||
* Acute fulminant/pernicious form (Shoshin beriberi): This form is characterized by rapid onset, progressive disease course, and poor prognosis (often fatal). | * Acute fulminant/pernicious form (Shoshin beriberi): This form is characterized by rapid onset, progressive disease course, and poor prognosis (often fatal). | ||
* Chronic wet beriberi: This form has a subtle onset and a gradual course and usually ends in high-output heart failure. | * Chronic wet beriberi: This form has a subtle onset and a gradual course and usually ends in high-output heart failure. | ||
|Individuals with chronic thiamine deficiency | | | ||
* Individuals with chronic [[thiamine deficiency]]. | |||
| | | | ||
*[[Heart failure]] (acute or chronic). | *[[Heart failure]] (acute or chronic). | ||
* Peripheral [[edema]]: | * Peripheral [[edema]]: Due to weakened capillary beds in peripheral tissues leading to fluid leakage. | ||
|- | |- | ||
!Dry beriberi | |||
!Peripheral nervous system | |||
|Usually follows a chronic disease course | | | ||
|Individuals with chronic [[thiamine]] | * Usually follows a chronic disease course. | ||
|[[Polyneuritis]] and symmetric, ascending paralysis of the peripheral | | | ||
* Individuals with chronic [[Thiamine deficiency|thiamine deficiency.]] | |||
| | |||
* [[Polyneuritis]] and symmetric, ascending paralysis of the [[peripheral nervous system]]. | |||
* It first affects the [[sensory system]] ([[Paresthesia|parasthesia]]), then the motor system (loss of tendon reflexes, followed by foot and [[wrist drop]]). | |||
|- | |- | ||
! rowspan="2" |Based on patient risk factor exposure | |||
!Infantile beriberi | |||
!Cardiovascular or nervous system | |||
|Usually follows a progressive disease course and has three distinct forms: | |Usually follows a progressive disease course and has three distinct forms: | ||
| Line 55: | Line 62: | ||
* Pseudomeningitic: 7 to 9 months old. | * Pseudomeningitic: 7 to 9 months old. | ||
|Early signs include restlessness, constipation, and vomiting. | |Early signs include restlessness, [[constipation]], and [[vomiting]]. | ||
* Cardiac form: Acute cardiac failure ([[edema]] and [[cyanosis]]). Once heart failure develops, the infant may die in two to four hours. | * Cardiac form: Acute cardiac failure ([[edema]] and [[cyanosis]]). Once heart failure develops, the infant may die in two to four hours. | ||
* Aphonic form: hoarseness, weak cry, and even loss of voice due to vocal cord paralysis. | * Aphonic form: hoarseness, weak cry, and even loss of voice due to vocal cord paralysis. | ||
* Pseudomeningitic form: The classic presentation of meningitis ([[nystagmus]], vomiting and [[Seizure|seizures]]); however, CSF analysis reveals no infectious organisms. | * Pseudomeningitic form: The classic presentation of meningitis ([[nystagmus]], vomiting and [[Seizure|seizures]]); however, CSF analysis reveals no infectious organisms. | ||
|- | |- | ||
!Wenicke-Korsakoff Syndrome | |||
!Brain | |||
|Two conditions: | |Two conditions: | ||
* Acute ([[Wernicke syndrome|Wernicke]]'s encephalopathy) | * Acute ([[Wernicke syndrome|Wernicke]]'s encephalopathy). | ||
* Chronic ([[Wernicke-Korsakoff syndrome|Korsakoff]] psychosis) | * Chronic ([[Wernicke-Korsakoff syndrome|Korsakoff]] psychosis). | ||
|[[Alcoholism|Chronic alcoholics]] (precipitated by high carbohydrate consumption that exacerbates subclinical thiamine deficiency) | | | ||
* [[Alcoholism|Chronic alcoholics]] (precipitated by high carbohydrate consumption that exacerbates subclinical thiamine deficiency). | |||
| | | | ||
* Wernicke's encephalopathy: Confusion, [[ataxia]], ptosis, and double vision. | * Wernicke's encephalopathy: Confusion, [[ataxia]], ptosis, and double vision. | ||
| Line 75: | Line 83: | ||
* Korsakoff psychosis: [[Hallucination|Hallucinations]], confabulation, and [[amnesia]]. | * Korsakoff psychosis: [[Hallucination|Hallucinations]], confabulation, and [[amnesia]]. | ||
|- | |- | ||
! | |||
!Bariatric beriberi | |||
!Nervous system | |||
|The condition may lead to: | |The condition may lead to: | ||
* Dry beriberi | * Dry beriberi | ||
* Wernicke-Korsakoff | *[[Wernicke-Korsakoff syndrome]] | ||
|Bariatric surgeries | |Bariatric surgeries | ||
* Common: Roux-en Y gastric bypass | * Common: Roux-en Y gastric bypass | ||
* Less common: post-adjustable gastric banding | * Less common: post-adjustable gastric banding | ||
|Within the first 6 months of surgery, patients may present with the manifestations of dry beriberi or more acutely, | |Within the first 6 months of surgery, patients may present with the manifestations of dry beriberi or more acutely, [[Wernicke-Korsakoff syndrome]]. | ||
|}<br /> | |}<br /> | ||
Latest revision as of 15:30, 24 January 2020
|
Beriberi Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Beriberi classification On the Web |
|
American Roentgen Ray Society Images of Beriberi classification |
|
Risk calculators and risk factors for Beriberi classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Abdelrahman Ibrahim Abushouk, MD[2]
Overview
Beriberi is usually classified into two types based on the main system affected (Wet and dry). The two forms may appear in the same patient, but one form dominates the disease phenotype. Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations.
Classification
- Beriberi is usually classified into two types based on the main system affected (Wet and dry).
- The two forms may appear in the same patient, but one form dominates the disease phenotype.
- Other forms as infantile beriberi or Wernicke-Korsakoff syndrome occur in special populations.[1][2][3][4][5]
| Affected Site | Course | Population | Presentation | ||
|---|---|---|---|---|---|
| Classification based on main organ-system affected | Wet beriberi | Cardiovascular System |
|
|
|
| Dry beriberi | Peripheral nervous system |
|
|
| |
| Based on patient risk factor exposure | Infantile beriberi | Cardiovascular or nervous system | Usually follows a progressive disease course and has three distinct forms:
|
Infants nursed by thiamine-deficient mothers.
|
Early signs include restlessness, constipation, and vomiting.
|
| Wenicke-Korsakoff Syndrome | Brain | Two conditions: |
|
| |
| Bariatric beriberi | Nervous system | The condition may lead to:
|
Bariatric surgeries
|
Within the first 6 months of surgery, patients may present with the manifestations of dry beriberi or more acutely, Wernicke-Korsakoff syndrome. |
References
- ↑ Meurin P (1996). "[Shoshin beriberi. A rapidly curable hemodynamic disaster]". Presse Med. 25 (24): 1115–8. PMID 8868953.
- ↑ "StatPearls". 2019. PMID 30725889.
- ↑ Sinha S, Kataria A, Kolla BP, Thusius N, Loukianova LL (2019). "Wernicke Encephalopathy-Clinical Pearls". Mayo Clin Proc. 94 (6): 1065–1072. doi:10.1016/j.mayocp.2019.02.018. PMID 31171116.
- ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH; et al. (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 62 (16): e147–239. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
- ↑ Aasheim ET (2008). "Wernicke encephalopathy after bariatric surgery: a systematic review". Ann Surg. 248 (5): 714–20. doi:10.1097/SLA.0b013e3181884308. PMID 18948797.