thiamine deficiency
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2021 ◽  
Vol 8 ◽  
Author(s):  
Hitomi Tanaka ◽  
Takatoshi Anno ◽  
Haruka Takenouchi ◽  
Hideyuki Iwamoto ◽  
Hideaki Kaneto ◽  
...  

Background: Patients with alcohol use disorder (AUD) may develop peripheral edema due to alcohol-related liver, renal, or heart disease. Thiamine deficiency is reported to occur in AUD and type 2 diabetes mellitus (T2DM). Thiamine deficiency may also cause peripheral edema. Thiamine is essential for optimal glucose metabolism through its role as an essential co-factor for key enzymes in intermediary metabolism. Since glucose metabolism worsens under diabetic conditions, it seems that a relative shortage of thiamine may occur more easily in patients with diabetes mellitus.Case Presentation: A 59-year-old Japanese man was admitted to the hospital with severe peripheral edema. His background history included alcohol liver disease (ALD), chronic renal failure (CRF), and T2DM. His body mass index (BMI) at admission was 37.7 kg/m2 and this represented a 30 kg increase in body weight over 2 months. Laboratory investigations showed anemia, liver and renal injury, hyperglycemia, and marginal hypothyroidism. The plasma thiamine diphosphate concentration was 20 ng/mL (reference range: 24–66 ng/mL). Diet therapy of 1,600 kcal/day and intravenous fursultiamine hydrochloride therapy (50 mg/once a day, seven days) was commenced in combination with intravenous diuretics. After one week, the plasma thiamine concentration was 853 ng/mL, and the patient's body weight had reduced by 18 kg.Conclusions: Patients with T2DM and AUD may develop severe peripheral edema in the context of marginal thiamine deficiency. Fursultiamine hydrochloride (50 mg/once a day, seven days) restored normal plasma thiamine concentrations and may have contributed to the rapid resolution of severe peripheral edema in this case. Empirical treatment with thiamine should be considered in patients with severe peripheral edema in the context of AUD and T2DM.


2021 ◽  
Vol 22 (24) ◽  
pp. 13337
Author(s):  
Sylwia Gul-Hinc ◽  
Anna Michno ◽  
Marlena Zyśk ◽  
Andrzej Szutowicz ◽  
Agnieszka Jankowska-Kulawy ◽  
...  

Brain pathologies evoked by thiamine deficiency can be aggravated by mild zinc excess. Cholinergic neurons are the most susceptible to such cytotoxic signals. Sub-toxic zinc excess aggravates the injury of neuronal SN56 cholinergic cells under mild thiamine deficiency. The excessive cell loss is caused by Zn interference with acetyl-CoA metabolism. The aim of this work was to investigate whether and how astroglial C6 cells alleviated the neurotoxicity of Zn to cultured SN56 cells in thiamine-deficient media. Low Zn concentrations did not affect astroglial C6 and primary glial cell viability in thiamine-deficient conditions. Additionally, parameters of energy metabolism were not significantly changed. Amprolium (a competitive inhibitor of thiamine uptake) augmented thiamine pyrophosphate deficits in cells, while co-treatment with Zn enhanced the toxic effect on acetyl-CoA metabolism. SN56 cholinergic neuronal cells were more susceptible to these combined insults than C6 and primary glial cells, which affected pyruvate dehydrogenase activity and the acetyl-CoA level. A co-culture of SN56 neurons with astroglial cells in thiamine-deficient medium eliminated Zn-evoked neuronal loss. These data indicate that astroglial cells protect neurons against Zn and thiamine deficiency neurotoxicity by preserving the acetyl-CoA level.


2021 ◽  
pp. 1753495X2110633
Author(s):  
Bonnie Huang ◽  
Jennifer H. Yo ◽  
Shital Gandhi ◽  
Cynthia Maxwell

Author(s):  
François Mifsud ◽  
Diane Messager ◽  
Anne-Sophie Jannot ◽  
Benoît Védie ◽  
Nadia Aissaoui Balanant ◽  
...  

Author(s):  
I. M. Todurov ◽  
O. O. Kalashnikov ◽  
O. V. Perekhrestenko ◽  
S. V. Kosiukhno ◽  
G. C. Chervyts ◽  
...  

The prevalence of morbid obesity has risen to global epidemic proportions. Bariatric surgery has been proven to be a safe and effective treatment for obesity with weight reduction, resolution of obesity-related co-morbidities, improved quality of life and an increased life expectancy. Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure worldwide. Obesity is associated with micronutrient deficiencies that results in the high prevalence of deficient vitamins status prior to bariatric surgery. After bariatric surgery, these micronutrient and vitamins deficiencies increase or occur de novo, and they may be threatening when left unattended. This presented clinical case demonstrates the clinical features of thiamine deficiency as well as the principles of laboratory and instrumental diagnostics. Electromyo­graphy is an informative method for diagnostic of muscle weakness. The lower serum thiamine level, neurological symptoms and electromyography results are the most important for the diagnosis of thiamine deficiency. Pathogenetic treatment can improve the patient’s condition in a short period of time. Although the SG is a purely restrictive procedure with no malabsorptive component, microelement or vitamin deficiency can occur in patients after procedure. The presented clinical case demonstrates the importance of timely thorough diagnosis and correct treatment of thiamine deficiency in patients after SG. Thus, patients after the LRS in deficiency of vitamin B1 may cause the development of neurological comp­lica­tions of varying severity, in particular dysmetabolic polyneuropathy. This condition is reversed and administration of an adequate and timely substitution therapy in patients with thiamine insufficiency allows be avoided the development of fatal complications.


Author(s):  
Catherine Crecraft ◽  
Jennifer Prittie

ABSTRACT Three dogs that presented to the emergency service in severely emaciated body conditions were admitted to the hospital for monitoring and refeeding. During their hospitalization, all three dogs developed electrolyte derangements or required supplementation to prevent hypophosphatemia and hypomagnesemia. Additionally, all dogs developed hyperlactatemia, which was suspected to be secondary to thiamine deficiency. Two dogs were reported to have cardiac abnormalities, including cardiac arrhythmias, systolic dysfunction, and spontaneous echogenic contrast. These cases highlight the complexity of refeeding syndrome and its associated complications that extend beyond electrolyte deficiencies.


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