Pediatric Beriberi Medication

  • Author: Simon S Rabinowitz, MD, PhD, FAAP; Chief Editor: Jatinder Bhatia, MBBS   more...
 
Updated: Apr 16, 2012
 

Medication Summary

The treatment of choice is thiamine hydrochloride (ie, aneurine hydrochloride, vitamin B-1). In a prospective study of the safety of thiamine hydrochloride, Wrenn et al evaluated 989 patients (1070 doses of 100 mg).[21] A total of 12 adverse reactions (1.1%) were reported. Minor reactions consisting of transient local irritation were observed in 11 patients (1.02%), and only one major reaction occurred (0.093%), consisting of generalized pruritus.

Several thiamine derivatives (eg, thiamine propyl disulfide [TPD], thiamine tetrahydrofurfuryl disulfide [TTFD]) have also been used to treat beriberi. These compounds are barely soluble in water. Even when orally administered, TPD and TTFD produce a higher thiamine level in the blood than thiamine hydrochloride.

If beriberi occurs in a breastfed infant, both the mother and child should be treated with thiamine. The physician should also be aware that thiamine deficiency can occur concurrently with other water soluble vitamin deficiencies.

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Vitamins

Class Summary

These agents are organic substances required by the body in small amounts for various metabolic processes. Vitamins may be synthesized in small or insufficient amounts in the body or may not be synthesized at all, thus requiring supplementation.

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Thiamine (Thiamilate)

 

Essential coenzyme that combines with ATP to form thiamine pyrophosphate. Dosage forms include a parenteral injection (100 mg/mL) and tablets.

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Contributor Information and Disclosures
Author

Simon S Rabinowitz, MD, PhD, FAAP  Professor of Clinical Pediatrics, Vice Chairman, Clinical Practice Development, Pediatric Gastroenterology, Hepatology, and Nutrition, State University of New York Downstate College of Medicine, The Children's Hospital at Downstate

Simon S Rabinowitz, MD, PhD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American College of Gastroenterology, American Gastroenterological Association, American Medical Association, New York Academy of Sciences, North American Society for Pediatric Gastroenterology and Nutrition, Phi Beta Kappa, and Sigma Xi

Disclosure: Abbott nutrition Honoraria Speaking and teaching

Coauthor(s)

L Arturo Batres, MD  Assistant Professor, Department of Pediatrics, Division of Gastroenterology and Nutrition, The Children's Hospital of the King's Daughters

L Arturo Batres, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for the Study of Liver Diseases, American Gastroenterological Association, and North American Society for Pediatric Gastroenterology and Nutrition

Disclosure: Nothing to disclose.

Sheela Moorthy, MD  Staff Physician, Department of Pediatrics, Richmond University Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Maria Rebello Mascarenhas, MBBS  Associate Professor of Pediatrics, University of Pennsylvania School of Medicine; Section Chief of Nutrition, Division of Gastroenterology and Nutrition, Director, Nutrition Support Service, Children's Hospital of Philadelphia

Maria Rebello Mascarenhas, MBBS is a member of the following medical societies: American Gastroenterological Association, American Society for Parenteral and Enteral Nutrition, and North American Society for Pediatric Gastroenterology and Nutrition

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Jatinder Bhatia, MBBS  Professor of Pediatrics, Chief, Section of Neonatology, Department of Pediatrics, Medical College of Georgia

Jatinder Bhatia, MBBS is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Dietetic Association, American Pediatric Society, American Society for Clinical Nutrition, American Society for Parenteral and Enteral Nutrition, Society for Pediatric Research, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Merrily P M Poth, MD  Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences

Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

Jatinder Bhatia, MBBS  Professor of Pediatrics, Chief, Section of Neonatology, Department of Pediatrics, Medical College of Georgia

Jatinder Bhatia, MBBS is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Dietetic Association, American Pediatric Society, American Society for Clinical Nutrition, American Society for Parenteral and Enteral Nutrition, Society for Pediatric Research, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

The authors gratefully acknowledge Dori Harasek for her assistance in the preparation of this chapter.

References

  1. Aasheim ET. Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg. Nov 2008;248(5):714-20. [Medline].

  2. Institute of Medicine of the National Academies. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington DC: National Academy Press; 1998:[Full Text].

  3. World Health Organization. Thiamine Deficiency and its prevention and control in major emergencies. 1999. [Full Text].

  4. McCandless DW, Schenker S, Cook M. Encephalopathy of thiamine deficieny: studies of intracerebral mechanisms. J Clin Invest. Oct 1968;47(10):2268-80. [Medline].

  5. Martin PR, Singleton CK, Hiller-Sturmhofel S. The role of thiamine deficiency in alcoholic brain disease. Alcohol Res Health. 2003;27(2):134-42. [Medline].

  6. Greenspon J, Perrone EE, Alaish SM. Shoshin beriberi mimicking central line sepsis in a child with short bowel syndrome. World J Pediatr. Nov 2010;6(4):366-8. [Medline].

  7. Muri RM, Von Overbeck J, Furrer J, Ballmer PE. Thiamin deficiency in HIV-positive patients: evaluation by erythrocyte transketolase activity and thiamin pyrophosphate effect. Clin Nutr. Dec 1999;18(6):375-8. [Medline].

  8. Fattal-Valevski A, Kesler A, Sela BA, et al. Outbreak of life-threatening thiamine deficiency in infants in Israel caused by a defective soy-based formula. Pediatrics. Feb 2005;115(2):e233-8. [Medline].

  9. Fattal-Valevski A, Azouri-Fattal I, Greenstein YJ, Guindy M, Blau A, Zelnik N. Delayed language development due to infantile thiamine deficiency. Dev Med Child Neurol. Aug 2009;51(8):629-34. [Medline].

  10. Hanninen SA, Darling PB, Sole MJ, Barr A, Keith ME. The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. J Am Coll Cardiol. Jan 17 2006;47(2):354-61. [Medline].

  11. Khounnorath S, Chamberlain K, Taylor AM, Soukaloun D, Mayxay M, Lee SJ, et al. Clinically unapparent infantile thiamin deficiency in Vientiane, Laos. PLoS Negl Trop Dis. Feb 22 2011;5(2):e969. [Medline]. [Full Text].

  12. Djoenaidi W, Notermans SL, Verbeek AL. Subclinical beriberi polyneuropathy in the low income group: an investigation with special tools on possible patients with suspected complaints. Eur J Clin Nutr. Aug 1996;50(8):549-55. [Medline].

  13. McGready R, Simpson JA, Cho T, et al. Postpartum thiamine deficiency in a Karen displaced population. Am J Clin Nutr. Dec 2001;74(6):808-13. [Medline].

  14. Ahoua L, Etienne W, Fermon F, et al. Outbreak of beriberi in a prison in Cote d'Ivoire. Food Nutr Bull. Sep 2007;28(3):283-90. [Medline].

  15. Fozi K, Azmi H, Kamariah H, Azwa MS. Prevalence of thiamine deficiency at a drug rehabilitation centre in Malaysia. Med J Malaysia. Dec 2006;61(5):519-25. [Medline].

  16. Morovvati S, Nakagawa M, Sato Y, Hamada K, Higuchi I, Osame M. Phenotypes and mitochondrial DNA substitutions in families with A3243G mutation. Acta Neurol Scand. Aug 2002;106(2):104-8. [Medline].

  17. Lira PI, Andrade SL. [Beriberi epidemic in Maranhão State, Brazil]. Cad Saude Publica. Jun 2008;24(6):1202-3. [Medline].

  18. Rao SN, Mani S, Madap K, Kumar MV, Singh L, Chandak GR. High prevalence of infantile encephalitic beriberi with overlapping features of Leigh's disease. J Trop Pediatr. Oct 2008;54(5):328-32. [Medline].

  19. Shivalkar B, Engelmann I, Carp L. Shoshin syndrome: two case reports representing opposite ends of the same disease spectrum. Acta Cardiol. 1998;53(4):195-9. [Medline].

  20. Lu J, Frank EL. Rapid HPLC measurement of thiamine and its phosphate esters in whole blood. Clin Chem. May 2008;54(5):901-6. [Medline].

  21. Wrenn KD, Murphy F, Slovis CM. A toxicity study of parenteral thiamine hydrochloride. Ann Emerg Med. Aug 1989;18(8):867-70. [Medline].

  22. Kitamura K, Yamaguchi T, Tanaka H, et al. TPN-induced fulminant beriberi: a report on our experience and a review of the literature. Surg Today. 1996;26(10):769-76. [Medline].

  23. Angstadt JD, Bodziner RA. Peripheral polyneuropathy from thiamine deficiency following laparoscopic Roux-en-Y gastric bypass. Obes Surg. Jun-Jul 2005;15(6):890-2. [Medline].

  24. Centers for Disease Control and Prevention. Lactic acidosis traced to thiamine deficiency related to nationwide shortage of multivitamins for total parenteral nutrition--United States, 1997. JAMA. Jul 9 1997;278(2):109, 111. [Medline].

  25. Indraccolo U, Gentile G, Pomili G, et al. Thiamine deficiency and beriberi features in a patient with hyperemesis gravidarum. Nutrition. Sep 2005;21(9):967-8. [Medline].

  26. Kornreich L, Bron-Harlev E, Hoffmann C, et al. Thiamine deficiency in infants: MR findings in the brain. AJNR Am J Neuroradiol. Aug 2005;26(7):1668-74. [Medline].

  27. Lehninger, Albert L. Vitamins and Coenzymes. In: Biochemistry. 2nd ed. New York, NY: Worth Publishers; 1977:337-9.

  28. Stryer, Lubert. Citric acid cycle. In: Biochemistry. 2nd ed. San Francisco, CA: Freeman; 1981:290-5.

  29. Suter PM, Vetter W. Diuretics and vitamin B1: are diuretics a risk factor for thiamin malnutrition?. Nutr Rev. Oct 2000;58(10):319-23. [Medline].

  30. Weise Prinzo Z, de Benoist B. Meeting the challenges of micronutrient deficiencies in emergency- affected populations. Proc Nutr Soc. May 2002;61(2):251-7. [Medline].

 
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