Thiamine Deficiency in a Nondrinker and Secondary Pulmonary Edema after Thiamine Replenishment.

Abstract

A 48-year-old man was brought to our emergency room with acute abdominal pain and systemic edema, indicating acute circulatory failure with lactic acidosis. Furosemide treatment paradoxically worsened the systemic edema and induced confusion. He had no drinking history but hardly ate legumes or meats containing thiamine. Administration of fursultiamine dramatically improved the symptoms and subsequently caused pulmonary edema. Thiamine deficiency may occur in nondrinkers with an unbalanced diet. In this condition, diuretic therapy can worsen the symptoms before thiamine supplementation by promoting the flushing of water-soluble vitamins but is needed for the management of secondary pulmonary edema after thiamine replenishment.

• Authors: Hiroyuki Nakamura, Ayano Utsunomiya, Yuriko Ishida, Tetsuya Horita
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 59 Issue 3 Pg. 373-376 (Feb 01 2020) ISSN: 1349-7235 [Electronic] Japan
• PMID: 31534090 (Publication Type: Case Reports, Journal Article)

Chemical References

• Fursultiamin
• Vitamin B Complex
• Thiamine

Topics

• Beriberi (diagnosis, drug therapy)
• Fursultiamin (adverse effects, therapeutic use)
• Humans
• Male
• Middle Aged
• Pulmonary Edema (chemically induced, drug therapy)
• Thiamine (therapeutic use)
• Thiamine Deficiency (complications, drug therapy)
• Treatment Outcome
• Vitamin B Complex (therapeutic use)