ArticleIntestinal Failure (New York, N.Y.)
Wet beriberi in intestinal failure due to change from intravenous to enteral supplementation - Time to focus on water-soluble vitamins.
Article in Intestinal Failure (New York, N.Y.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Thiamine deficiency is a rare but life-threatening complication for which children on long term parenteral nutrition (PN) are at higher risk. Case report: We describe a 13-year-old male with intestinal failure secondary to Filamin A mutation who presented with one-week of oedema and orthopnoea. He was fully dependent on PN and his intravenous multivitamin supplementation was replaced with enteral vitamins due to a national shortage. On presentation he was tachycardic, tachypnoeic, hypotensive, and fluid overloaded. Investigations revealed hyponatraemia, hypoalbuminaemia, metabolic acidosis, and a significantly elevated lactate. Chest radiography showed bilateral pleural effusions. Intravenous thiamine and oral vitamin C supplementation led to rapid clinical improvement and testing confirmed low thiamine and vitamin C levels. His presentation was consistent with wet beriberi due to thiamine deficiency. Conclusion: This case highlights the risk of water-soluble vitamin deficiency in PN-dependent children during intravenous vitamin shortages and the need for biochemical monitoring.
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