Pediatric Beriberi Treatment & Management

  • Author: Simon S Rabinowitz, MD, PhD; Chief Editor: Jatinder Bhatia, MBBS   more...
 
Updated: Sep 18, 2009
 

Medical Care

  • Monitor patients with cardiac failure in an intensive care unit.
  • Because beriberi often presents with other vitamin B deficiencies, administer a complete vitamin B complex.
  • After the high-output state has been addressed with thiamine, patients can go into standard congestive heart failure and, thus, may require ongoing cardiology consultation, possibly remaining in an intensive care unit.
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Consultations

  • Cardiologic evaluation with 2-dimensional echocardiography is necessary.
    • Essential for diagnosis and management of beriberi
    • Reveals congestive heart failure and the poor ventricular function observed in beriberi
    • Assists in cardiac dysfunction that remains after thiamine administration.
  • Neurologic and psychiatric consultations are usually necessary. If dry beriberi has progressed, ongoing care is required.
  • Nutritional consultation should be aimed at preventing a recurrence of the deficiency.
  • For psychosocial causes, support counseling is essential to avoid recurrence. Specialized multidisciplinary teams are advisable for patients with chronic alcoholism to monitor their future course. Comprehensive follow-up programs are necessary to minimize recidivism in most cases of nutritional beriberi.
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Diet

  • Patients with lethargy, confusion, and severe heart failure need to be kept on a diet of nothing by mouth (NPO) to prevent aspiration.
  • Dietary sources of thiamine (see Pathophysiology) must be emphasized along with ongoing supplementation.
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Activity

  • Patients who present with congestive heart failure should have activity restricted.
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Contributor Information and Disclosures
Author

Simon S Rabinowitz, MD, PhD  Professor of Clinical Pediatrics, New York Medical College; Chairman, Chief and Medical Administrator, Department of Pediatrics, Chief, Pediatric Gastroenterology and Nutrition, Richmond University Medical Center

Simon S Rabinowitz, MD, PhD 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: Nothing to disclose.

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 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; Pharmacy Editor, eMedicine

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 Lawson-Wilkins 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.

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