Pediatric Beriberi Treatment & Management

Updated: Oct 04, 2018
  • Author: Simon S Rabinowitz, MD, PhD, FAAP; Chief Editor: Jatinder Bhatia, MBBS, FAAP  more...
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Treatment

Medical Care

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  • 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

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  • 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

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  • 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

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  • Patients who present with congestive heart failure should have activity restricted.

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