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Shoshin Beriberi in an Adult Patient following Severely-impaired Peripheral Neuropathy Ryuta Imaki 1 , Takayuki Inomata 1 , Narihisa Matsuyama 1 , Toshimitsu Ide 2 , Masahumi Watanabe 1 , Shingo Kurokawa 1 , Toru Izumi 1 1Department of Internal Medicine & Cardiology, Kitasato University School of Medicine 2Department of Internal Medicine & Neurology, Kitasato University School of Medicine Keyword: 脚気心 , ギランバレー症候群 , ウェルニッケ脳症 , beriberi heart , Guillain-Barre syndrome , Wernicke encephalopathy pp.647-651
Published Date 2005/6/1
DOI https://doi.org/10.11477/mf.1404100074
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Summary

 A 26-year-old man, living in poverty on an unbalanced diet, had flu-like symptoms following weakness of his limbs at the end of March, 2003. His neurological dysfunction gradually improved under in-hospital management according to the initial diagnosis of Guillain-Barre syndrome. On April 21, he suddenly suffered cardiogenic shock. Cardiological examination showed severely-impaired left ventricular contractions together with rapid progress of intraventricular conduction disturbance. He died on April 25 due to sustained low blood pressure accompanied by decreased systemic vascular resistance despite artificial hemodynamic supports. The autopsy demonstrated myocardial degeneration without any stenotic coronary arteries and myocardial inflammation in addition to noninflammatory axonal degeneration in peripheral nerves together with petechiae in mammillary bodies. These clinical and pathological findings led to the final diagnosis of Shoshin beriberi and Wernicke encephalopathy with preceding severely-impaired peripheral neuropathy. It is important even nowadays to bear in mind the possibility of beriberi for the differential diagnosis of heart failure.


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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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