PDF(Pubmed)
Abstract：
UNASSIGNED: Thiamine deficiency, also known as beriberi, is a nutritional disorder caused by a lack of thiamine (vitamin B1) in the diet. It can occur in 2 forms: dry beriberi, which affects the nervous system, and wet beriberi, which affects the cardiovascular system. Gastrointestinal beriberi is a subtype that affects the digestive system and can lead to multisystem involvement. In the United States (US), thiamine deficiency often arises from chronic malnutrition secondary to alcoholism, known as Wernicke-Korsakoff Syndrome.
UNASSIGNED: A 45-year-old female with no known past medical history or alcohol use disorder came to the emergency department with an altered mental status and with a history of intractable nausea and vomiting for several months prior to presentation. During intake, the medical team discovered she had bilateral lower extremity weakness and an anion gap metabolic acidosis. Her inpatient workup ruled out meningitis, encephalitis, peritonitis, diabetic ketoacidosis, and cerebrovascular accident. A thiamine deficiency was the most probable cause of her presentation, secondary to her protracted history of vomiting and poor oral medication intake. Refeeding syndrome complicated her hospitalization. After replenishing thiamine, the patient experienced significant improvement in mental status and lower extremity weakness. The healthcare team later discharged her with home physical therapy rehabilitation and nutritional counseling.
UNASSIGNED: Thiamine deficiency is not common in the US. However, this case highlights the importance of including this deficiency in the differential when a patient arrives with a history of malnourishment secondary to a gastrointestinal illness with signs of altered mental status and neurological symptoms.
UNASSIGNED: A 45-year-old female with no known past medical history or alcohol use disorder came to the emergency department with an altered mental status and with a history of intractable nausea and vomiting for several months prior to presentation. During intake, the medical team discovered she had bilateral lower extremity weakness and an anion gap metabolic acidosis. Her inpatient workup ruled out meningitis, encephalitis, peritonitis, diabetic ketoacidosis, and cerebrovascular accident. A thiamine deficiency was the most probable cause of her presentation, secondary to her protracted history of vomiting and poor oral medication intake. Refeeding syndrome complicated her hospitalization. After replenishing thiamine, the patient experienced significant improvement in mental status and lower extremity weakness. The healthcare team later discharged her with home physical therapy rehabilitation and nutritional counseling.
UNASSIGNED: Thiamine deficiency is not common in the US. However, this case highlights the importance of including this deficiency in the differential when a patient arrives with a history of malnourishment secondary to a gastrointestinal illness with signs of altered mental status and neurological symptoms.
摘要：
■硫胺素缺乏症，也被称为脚气病，是由饮食中缺乏硫胺素（维生素B1）引起的营养障碍。它可以以两种形式出现：干脚气病，影响神经系统，和湿的脚气病,影响心血管系统。胃肠脚气病是一种影响消化系统并可导致多系统参与的亚型。在美国（US），硫胺素缺乏通常由慢性营养不良继发酒精中毒，被称为Wernicke-Korsakoff综合症.
一名45岁女性，没有已知的既往病史或酒精使用障碍，在就诊前几个月出现顽固性恶心和呕吐病史，来到急诊科就诊。在摄入过程中,医疗小组发现她患有双侧下肢无力和阴离子间隙代谢性酸中毒。她的住院体检排除了脑膜炎,脑炎,腹膜炎,糖尿病酮症酸中毒,和脑血管意外。硫胺素缺乏是她出现的最可能原因，继发于她长期的呕吐史和口服药物摄入不良。再喂养综合征使她的住院复杂化。补充硫胺素后，患者经历了精神状况和下肢无力的显著改善。医疗团队后来通过家庭物理治疗康复和营养咨询使她出院。
■硫胺素缺乏症在美国并不常见。然而,该病例强调了当患者患有继发于胃肠道疾病的营养不良史并伴有精神状态和神经系统症状改变的症状时，将这种缺陷纳入差异的重要性。
一名45岁女性，没有已知的既往病史或酒精使用障碍，在就诊前几个月出现顽固性恶心和呕吐病史，来到急诊科就诊。在摄入过程中,医疗小组发现她患有双侧下肢无力和阴离子间隙代谢性酸中毒。她的住院体检排除了脑膜炎,脑炎,腹膜炎,糖尿病酮症酸中毒,和脑血管意外。硫胺素缺乏是她出现的最可能原因，继发于她长期的呕吐史和口服药物摄入不良。再喂养综合征使她的住院复杂化。补充硫胺素后，患者经历了精神状况和下肢无力的显著改善。医疗团队后来通过家庭物理治疗康复和营养咨询使她出院。
■硫胺素缺乏症在美国并不常见。然而,该病例强调了当患者患有继发于胃肠道疾病的营养不良史并伴有精神状态和神经系统症状改变的症状时，将这种缺陷纳入差异的重要性。
