1996 Volume 57 Issue 8 Pages 2036-2040
Shoshin beriberi is a state of cardiovascular collapse due to metabolic acidosis caused by vitamin B1 (thiamine) deficiency.
A 36-year-old female was admitted to the hospital because of disturbance of consciousness and edema in the lower extremities and face. She had taken only precooked foods for long periods. Hemodynamic abnormalities with a high cardiac output (5.871/min/m2) and high CVP (18 cmH2O) were observed in a state of severe metabolic acidosis (pH 6.87, BE-21.4mEq/l). Chest X-ray film demonstrated slightly enlarged cardiac size. CT and ultrasound studies revealed the dilated inferior vena cava and enlarged spleen and liver. In cardiac ultrasound test, pericardial effusion was noticed. The circulatory failure and metabolic acidosis were resistant to the intensive therapy with catecholamines, sodium bicarbonate and various fluid transfusions.
After administration of thiamine (200 mg IV every day for 4 days), the abnormalities of hemodynamics and acid base balance returned to normal range. Consciousness state also recovered to normal condition in 5 hours after thiamine therapy.
In conclusion shoshin beriberi should be considered in patients with malnutrition or alcoholic who develop cardiac failure or metabolic acidosis of unexplained etiology.
