Difference between revisions of "Beriberi" - New World Encyclopedia
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| − | '''Beriberi''' is a [[disease]] caused by [[thiamine]] (vitamin B<sub>1</sub>) deficiency. It affects a variety of organs and systems of the [[human body|body]], including the nervous system, digestive system, heart, and muscles. | + | '''Beriberi''' is a [[disease]] caused by [[thiamine]] (vitamin B<sub>1</sub>) deficiency. It affects a variety of organs and systems of the [[human body|body]], including the nervous system, digestive system, heart, and muscles. If untreated, it is fatal. |
| + | Beriberi is not common in developed nations, but is associated with alcoholism and gastroinstinal disorders. It is endemic, and rates can be quite high, in a number of developing nations, including areas of Asia where people subsist on polished rice, in which the outer husk is removed. (Chamberllin and Narins 2005). | ||
| − | ==Overview== | + | ==Overview and prevelance== |
| − | Thiamine is | + | Thiamine (or thiamin) is one of the ''[[Vitamin B|B vitamins]]'', a group of chemically distinct, water-soluble vitamins that also includes [[riboflaven]], [[niacin]], pantothenic acid, pyridoxine, [[biotin]], folic acid, and others. Thiamine is integral to the complex coordination of the [[Krebs cycle]], which is the main biochemical pathway to extract energy from [[glucose]], [[amino acid]]s, and [[fat]] (Podel 1999). Thiamine is essential for normal growth and development and helps to maintain proper functioning of the [[heart]] and the [[nervous system|nervous]] and [[digestive system]]s. It serves as a co-enzyme in the pathway to synthesize [[NAD|NADPH]] and the pentose sugars [[deoxyribose]] and [[ribose]], the later two of which are the [[carbohydrate|sugars]] for [[DNA]] and [[RNA]], respectively. |
| + | Since it is water-soluble, thiamine cannot be stored in the [[human body|body]]; however, once absorbed, the vitamin is concentrated in [[muscle]] tissue. Among good sources of thiamine are various [[vegetable]]s, including [[legume]]s and [[pea|green peas]], as well as [[liver]], nuts, and yeast. In the developed countries, many foods are enriched with Vitamin B<sub>1</sub>. | ||
| + | The aleurone layer of unpolished rice is a rich source. | ||
| − | + | Thiamine was first discovered in 1910 by [[Umetaro Suzuki]]* in [[Japan]] when researching how [[rice]] bran cured patients of [[beriberi]]. Until that time, it was a mystery why beriberi was affecting so many people of all ages in Asia, and only in the early 1900s was it realized thar rice bran contained something to prevent it. To get white rice, the bran was being removed. | |
| + | reliance on white rice as a staple food. | ||
| − | + | Well-known syndromes caused by thiamine deficiency include Wernicke-Korsakoff syndrome (the syndrome caused by thiamine deficienty in acholholism) and, of course, beriberi. Systemic thiamine deficiency can lead to myriad problems, including neurodegeneration, wasting, and death. A lack of thiamine can be caused by malnutrition, [[alcoholism]], a diet high in [[thiaminase]]-rich foods (raw freshwater [[fish]], raw shellfish, [[fern]]s), and/or foods high in anti-thiamine factors ([[tea]], [[coffee]], betel nuts) (Higdon 2002). | |
| − | |||
| − | + | It is common in people whose [[diet (nutrition)|diet]] consists mainly of polished [[white rice]] (which contains little or no thiamine because the husk, which contains most of the thiamine, has been removed) and in chronic [[alcoholism|alcoholic]]s with impaired [[liver]] function; it is also a known (though rare) potential side effect of [[gastric bypass surgery]]. If a baby consumes the [[milk]] of a mother who suffers from thiamine deficiency, the child may develop beriberi. | |
| + | |||
| + | In some areas of Asia, where white (polished) rice is a staple food—that is, wehre the husk is removed— thre rates of beriberi can be quite hight, includig up to 66% among low-income families in certain parts of Indonesia (Chamberlin and Narins 2005). | ||
| + | |||
| + | ==Types of beriberi== | ||
| − | |||
There are two forms of the disease: '''wet beriberi''' and '''dry beriberi'''. | There are two forms of the disease: '''wet beriberi''' and '''dry beriberi'''. | ||
Wet beriberi affects the [[heart]]; it is sometimes fatal, as it causes a combination of [[congestive heart failure|heart failure]] and weakening of the [[capillary]] walls, which causes the peripheral tissues to become waterlogged. Dry beriberi causes wasting and partial [[paralysis]] resulting from damaged peripheral [[nerve]]s. It is also referred to as ''endemic neuritis''. | Wet beriberi affects the [[heart]]; it is sometimes fatal, as it causes a combination of [[congestive heart failure|heart failure]] and weakening of the [[capillary]] walls, which causes the peripheral tissues to become waterlogged. Dry beriberi causes wasting and partial [[paralysis]] resulting from damaged peripheral [[nerve]]s. It is also referred to as ''endemic neuritis''. | ||
| + | |||
| + | wet (heart and circulation) | ||
| + | |||
| + | Both in same patient, but one more dominate | ||
| + | |||
| + | Chamberlin and Narins (2005) note two other main categories of the disease. Shoshin, a form of wet (or cardiovascular) beriberi .. rapid appearance ; | ||
| + | |||
| + | There are four main types of beriberi: wet beriberi, dry beriberi, shoshin, and infantile beriberi (Chamberlin and Narins 2005). Web beriberi primarily impacts the cardiovascular system, dry beriberi affects primarily the nervous system, shoshin is a rapidly progressing and often fatal form of cardiovascular impacts, and infantile beriberi strikes babies between the age of one and four moths who are breastfed by mothers deficient in thiamine (Chamberlain and Narins 2005). | ||
| + | |||
| + | |||
| + | Teh Wernicke-Korsakoff syndrom (cerebral beriberi) occus in chronic alcoholics nad affects the central nervous system. | ||
| + | |||
| + | ==Symptoms== | ||
| + | Overall, symptoms of beriberi include weight loss, [[emotion]]al disturbances, impaired [[sense|sensory]] [[perception]] ([[Wernicke's encephalopathy]]), [[muscle weakness|weakness]] and [[pain and nociception|pain]] in the limbs, and periods of irregular [[heart rate]]. [[Edema]] (swelling of [[human anatomy|bodily]] tissues) is common. In advanced cases, the [[disease]] may cause [[heart failure]] and [[death]]. | ||
| + | |||
| + | Dry beriberi, whch affects the nervous system, tends to produce sysmpts of numbness, tingling, and burning pain in the extremeties and cramping i the leg muscles, as well as difficulty wiht speech and sense of balance (Chamberlin and Narins 2005). Wet beriberi, which affects the cardiovascular system, includes symptons of a fast heart beat, enlarged heart and liver, shortness of breath, swollen legs and feet, and lung congestion (Chamberlin and Narins 2005). Shoshin produces the same symptons, but with sudden onset and rapid progression. Infantile beriberi exhibits as difficulty sleeping, restlessness, diarrhead, swollen extremities, muscle wasting, and silent cry (Chamberlin and Narins 2005). | ||
| + | |||
| + | |||
| + | these symptoms are caused by abnormal metabolism of carbohydrates, resulting i decreased energy production, and injury to the heart and nervous system (Chamberlin and Narins 2005). Thiamine needed for reactions that produce energy from glucose or convert glucose to fat. | ||
| + | |||
| + | |||
| + | For example when the muscles do not get enough energy from glucose, body cannot produce more . | ||
| + | |||
| + | The origin of the word is from a [[Sinhalese language|Sinhalese]] phrase meaning "I cannot, I cannot", showing the impact on the muscles, cardiovascular, and nervous system. | ||
| + | |||
| + | ==Diagnosis== | ||
| + | |||
| + | Diagnosis includes taking a history of the patient to look for causes of deficientcy, physical examination for expected signs (swelling, problems with balance, etc.), and laboratory testing to demonstrate thiamine deficiency (Chamberlin and Narins 2005). | ||
| + | |||
| + | |||
| + | A positive diagnosis test for thiamine deficiency can be ascertained by measuring the activity of transketolase in [[erythrocyte]]s . Thiamine can also be measured directly in whole blood following the conversion of thiamine to a fluorescent thiochrome derivative. | ||
| + | |||
| + | Other laboratory measurements include tests for the chemicals lactate and pyruvate in the blood, which will be elevate in beriberi, and tests for the amount of thiamine passed into the urine, which will be low in cases of beriberi. | ||
| + | |||
| + | Diagnosis as beriberi may also be made by administering thiamine and see if the symptons are resolved. | ||
== Treatment == | == Treatment == | ||
| − | Treatment is with thiamine hydrochloride, either in tablet form or | + | Treatment is with thiamine hydrochloride, either in tablet form, injection, or in severe cases through an (intravenously (into a vein) IV. Magnesium is usually administered as well, sinc eit is required for proper functioning of thiamine (Chamberlin and Narins 2005). A rapid and dramatic recovery within hours can be made when this is administered to patients with beriberi, and their health can be transformed within an hour of administration of the treatment. Vitamin supplements and good nuttrition in the diet is required subsequently. |
==References== | ==References== | ||
* Chamberlin, Stacey L., and Brigham Narins. 2005. The Gale encyclopedia of neurological disorders. Detroit: Thomson Gale. ISBN 078769150X. | * Chamberlin, Stacey L., and Brigham Narins. 2005. The Gale encyclopedia of neurological disorders. Detroit: Thomson Gale. ISBN 078769150X. | ||
| + | |||
| + | * Higdon, J. 2002. [http://lpi.oregonstate.edu/infocenter/vitamins/thiamin/index.html Thiamin]. ''Micronutrient Information Center'' (Oregon State University: Linus Pauling Institute). Retrieved March 15, 2007. | ||
| + | * Podel, R. N. 1999. [http://www.newhope.com/nutritionsciencenews/NSN_backs/Jan_99/thiamine.cfm Thiamine's mood-mending qualities]. ''Nutrition Science News''. Retrieved March 15, 2007. | ||
| + | |||
| + | |||
Revision as of 03:29, 8 April 2007
| Beriberi Classification and external resources | |
 | |
|---|---|
| Thiamine | |
| ICD-10 | E51.1 |
| ICD-9 | 265.0 |
| DiseasesDB | 14107 |
| eMedicine | ped/229 med/221 |
| MeSH | D001602 |
Beriberi is a disease caused by thiamine (vitamin B1) deficiency. It affects a variety of organs and systems of the body, including the nervous system, digestive system, heart, and muscles. If untreated, it is fatal.
Beriberi is not common in developed nations, but is associated with alcoholism and gastroinstinal disorders. It is endemic, and rates can be quite high, in a number of developing nations, including areas of Asia where people subsist on polished rice, in which the outer husk is removed. (Chamberllin and Narins 2005).
Overview and prevelance
Thiamine (or thiamin) is one of the B vitamins, a group of chemically distinct, water-soluble vitamins that also includes riboflaven, niacin, pantothenic acid, pyridoxine, biotin, folic acid, and others. Thiamine is integral to the complex coordination of the Krebs cycle, which is the main biochemical pathway to extract energy from glucose, amino acids, and fat (Podel 1999). Thiamine is essential for normal growth and development and helps to maintain proper functioning of the heart and the nervous and digestive systems. It serves as a co-enzyme in the pathway to synthesize NADPH and the pentose sugars deoxyribose and ribose, the later two of which are the sugars for DNA and RNA, respectively.
Since it is water-soluble, thiamine cannot be stored in the body; however, once absorbed, the vitamin is concentrated in muscle tissue. Among good sources of thiamine are various vegetables, including legumes and green peas, as well as liver, nuts, and yeast. In the developed countries, many foods are enriched with Vitamin B1. The aleurone layer of unpolished rice is a rich source.
Thiamine was first discovered in 1910 by Umetaro Suzuki in Japan when researching how rice bran cured patients of beriberi. Until that time, it was a mystery why beriberi was affecting so many people of all ages in Asia, and only in the early 1900s was it realized thar rice bran contained something to prevent it. To get white rice, the bran was being removed. reliance on white rice as a staple food.
Well-known syndromes caused by thiamine deficiency include Wernicke-Korsakoff syndrome (the syndrome caused by thiamine deficienty in acholholism) and, of course, beriberi. Systemic thiamine deficiency can lead to myriad problems, including neurodegeneration, wasting, and death. A lack of thiamine can be caused by malnutrition, alcoholism, a diet high in thiaminase-rich foods (raw freshwater fish, raw shellfish, ferns), and/or foods high in anti-thiamine factors (tea, coffee, betel nuts) (Higdon 2002).
It is common in people whose diet consists mainly of polished white rice (which contains little or no thiamine because the husk, which contains most of the thiamine, has been removed) and in chronic alcoholics with impaired liver function; it is also a known (though rare) potential side effect of gastric bypass surgery. If a baby consumes the milk of a mother who suffers from thiamine deficiency, the child may develop beriberi.
In some areas of Asia, where white (polished) rice is a staple food—that is, wehre the husk is removed— thre rates of beriberi can be quite hight, includig up to 66% among low-income families in certain parts of Indonesia (Chamberlin and Narins 2005).
Types of beriberi
There are two forms of the disease: wet beriberi and dry beriberi.
Wet beriberi affects the heart; it is sometimes fatal, as it causes a combination of heart failure and weakening of the capillary walls, which causes the peripheral tissues to become waterlogged. Dry beriberi causes wasting and partial paralysis resulting from damaged peripheral nerves. It is also referred to as endemic neuritis.
wet (heart and circulation)
Both in same patient, but one more dominate
Chamberlin and Narins (2005) note two other main categories of the disease. Shoshin, a form of wet (or cardiovascular) beriberi .. rapid appearance ;
There are four main types of beriberi: wet beriberi, dry beriberi, shoshin, and infantile beriberi (Chamberlin and Narins 2005). Web beriberi primarily impacts the cardiovascular system, dry beriberi affects primarily the nervous system, shoshin is a rapidly progressing and often fatal form of cardiovascular impacts, and infantile beriberi strikes babies between the age of one and four moths who are breastfed by mothers deficient in thiamine (Chamberlain and Narins 2005).
Teh Wernicke-Korsakoff syndrom (cerebral beriberi) occus in chronic alcoholics nad affects the central nervous system.
Symptoms
Overall, symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception (Wernicke's encephalopathy), weakness and pain in the limbs, and periods of irregular heart rate. Edema (swelling of bodily tissues) is common. In advanced cases, the disease may cause heart failure and death.
Dry beriberi, whch affects the nervous system, tends to produce sysmpts of numbness, tingling, and burning pain in the extremeties and cramping i the leg muscles, as well as difficulty wiht speech and sense of balance (Chamberlin and Narins 2005). Wet beriberi, which affects the cardiovascular system, includes symptons of a fast heart beat, enlarged heart and liver, shortness of breath, swollen legs and feet, and lung congestion (Chamberlin and Narins 2005). Shoshin produces the same symptons, but with sudden onset and rapid progression. Infantile beriberi exhibits as difficulty sleeping, restlessness, diarrhead, swollen extremities, muscle wasting, and silent cry (Chamberlin and Narins 2005).
these symptoms are caused by abnormal metabolism of carbohydrates, resulting i decreased energy production, and injury to the heart and nervous system (Chamberlin and Narins 2005). Thiamine needed for reactions that produce energy from glucose or convert glucose to fat.
For example when the muscles do not get enough energy from glucose, body cannot produce more .
The origin of the word is from a Sinhalese phrase meaning "I cannot, I cannot", showing the impact on the muscles, cardiovascular, and nervous system.
Diagnosis
Diagnosis includes taking a history of the patient to look for causes of deficientcy, physical examination for expected signs (swelling, problems with balance, etc.), and laboratory testing to demonstrate thiamine deficiency (Chamberlin and Narins 2005).
A positive diagnosis test for thiamine deficiency can be ascertained by measuring the activity of transketolase in erythrocytes . Thiamine can also be measured directly in whole blood following the conversion of thiamine to a fluorescent thiochrome derivative.
Other laboratory measurements include tests for the chemicals lactate and pyruvate in the blood, which will be elevate in beriberi, and tests for the amount of thiamine passed into the urine, which will be low in cases of beriberi.
Diagnosis as beriberi may also be made by administering thiamine and see if the symptons are resolved.
Treatment
Treatment is with thiamine hydrochloride, either in tablet form, injection, or in severe cases through an (intravenously (into a vein) IV. Magnesium is usually administered as well, sinc eit is required for proper functioning of thiamine (Chamberlin and Narins 2005). A rapid and dramatic recovery within hours can be made when this is administered to patients with beriberi, and their health can be transformed within an hour of administration of the treatment. Vitamin supplements and good nuttrition in the diet is required subsequently.
ReferencesISBN links support NWE through referral fees
- Chamberlin, Stacey L., and Brigham Narins. 2005. The Gale encyclopedia of neurological disorders. Detroit: Thomson Gale. ISBN 078769150X.
- Higdon, J. 2002. Thiamin. Micronutrient Information Center (Oregon State University: Linus Pauling Institute). Retrieved March 15, 2007.
- Podel, R. N. 1999. Thiamine's mood-mending qualities. Nutrition Science News. Retrieved March 15, 2007.
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