1
|
Hahm JH, Nirmala FS, Ha TY, Ahn J. Nutritional approaches targeting mitochondria for the prevention of sarcopenia. Nutr Rev 2024; 82:676-694. [PMID: 37475189 DOI: 10.1093/nutrit/nuad084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
A decline in function and loss of mass, a condition known as sarcopenia, is observed in the skeletal muscles with aging. Sarcopenia has a negative effect on the quality of life of elderly. Individuals with sarcopenia are at particular risk for adverse outcomes, such as reduced mobility, fall-related injuries, and type 2 diabetes mellitus. Although the pathogenesis of sarcopenia is multifaceted, mitochondrial dysfunction is regarded as a major contributor for muscle aging. Hence, the development of preventive and therapeutic strategies to improve mitochondrial function during aging is imperative for sarcopenia treatment. However, effective and specific drugs that can be used for the treatment are not yet approved. Instead studies on the relationship between food intake and muscle aging have suggested that nutritional intake or dietary control could be an alternative approach for the amelioration of muscle aging. This narrative review approaches various nutritional components and diets as a treatment for sarcopenia by modulating mitochondrial homeostasis and improving mitochondria. Age-related changes in mitochondrial function and the molecular mechanisms that help improve mitochondrial homeostasis are discussed, and the nutritional components and diet that modulate these molecular mechanisms are addressed.
Collapse
Affiliation(s)
- Jeong-Hoon Hahm
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
| | - Farida S Nirmala
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Tae Youl Ha
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Jiyun Ahn
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| |
Collapse
|
2
|
Nisar S, Yousuf wani I, Altaf U, Muzaffer U, Kareem O, Tanvir M, Ganie MA. Thiamine deficiency-related neuropathy: A reversible entity from an endemic area. Eur J Neurol 2024; 31:e16155. [PMID: 38018774 PMCID: PMC11235669 DOI: 10.1111/ene.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/09/2023] [Accepted: 10/31/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND AND PURPOSE Despite thiamine deficiency being a lesser-known entity in modern times, beriberi in various forms, including thiamine deficiency-related neuropathy, remains endemic in Kashmir due to the consumption of polished rice as a staple food. This observational study investigates cases of peripheral neuropathy of unknown etiology and their potential responsiveness to thiamine administration. METHODS This prospective study enrolled adult patients presenting to the emergency department with weakness consistent with thiamine deficiency-related neuropathy and conducted a therapeutic challenge with thiamine on 41 patients. Response to thiamine therapy was monitored based on subjective and objective improvements in weakness and power. Patients were divided into thiamine responders (n = 25) and nonresponders (n = 16) based on their response to thiamine therapy and nerve conduction studies. RESULTS Most of the baseline characteristics were similar between responders and nonresponders, except the responders exhibited lower thiamine levels and higher partial pressure of oxygen and lactate levels compared to nonresponders. All patients had a history of consuming polished rice and traditional salt tea. Although weakness in the lower limbs was present in both groups, nonresponders were more likely to exhibit weakness in all four limbs. Clinical improvement was observed within 24 h, but proximal muscle weakness persisted for an extended period of time. CONCLUSIONS Thiamine deficiency-related neuropathy presents with predominant lower limb weakness, exacerbated by vomiting, poor food intake, psychiatric illness, and pregnancy. Thiamine challenge should be followed by observation of clinical and biochemical response.
Collapse
Affiliation(s)
- Sobia Nisar
- Department of MedicineGovernment Medical College and Associated SMHS Hospital SrinagarSrinagarIndia
| | | | - Umair Altaf
- Department of MedicineGovernment Medical College and Associated SMHS Hospital SrinagarSrinagarIndia
| | - Umar Muzaffer
- Department of MedicineGovernment Medical College and Associated SMHS Hospital SrinagarSrinagarIndia
| | - Ozaifa Kareem
- Department of Pharmaceutical SciencesUniversity of KashmirSrinagarIndia
| | - Masood Tanvir
- Department of MedicineGovernment Medical CollegeSrinagarIndia
| | - Mohd. Ashraf Ganie
- Department of EndocrinologySher‐i‐Kashmir Institute of Medical SciencesSrinagarIndia
| |
Collapse
|
3
|
Onizawa N, Ishida M, Uchida N, Sato I, Yoshioka A, Ito H, Onishi H. Is a decrease in activities of daily living in the elderly irreversible? A case report of Wernicke encephalopathy in home medical care. J Gen Fam Med 2022; 23:180-182. [PMID: 35509342 PMCID: PMC9062558 DOI: 10.1002/jgf2.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
The patient was an 83-year-old male who, after being hospitalized for 70 days for suffocation due to aspiration, was provided with home medical care (HMC) as his physical condition did not allow him to climb stairs. Wernicke encephalopathy (WE) was suspected based on his disorientation and a continued loss of appetite. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after thiamine administration. In addition, he became able to use stairs. Patients who receive HMC should undergo active screening and receive treatment with WE in mind.
Collapse
Affiliation(s)
| | - Mayumi Ishida
- Department of Psycho‐oncologySaitama Medical University International Medical CenterHidaka CitySaitamaJapan
| | - Nozomu Uchida
- Department of General MedicineOgano Central HospitalOgano TownSaitamaJapan
| | - Izumi Sato
- Department of Clinical EpidemiologyGraduate School of Biomedical SciencesNagasaki UniversityNagasaki CityNagasakiJapan
| | - Akira Yoshioka
- Department of Medical OncologyMitsubishi Kyoto HospitalKyoto CityKyotoJapan
| | - Hiroshi Ito
- Department of General MedicineIto Internal Medicine and Pediatric ClinicFukuoka CityFukuokaJapan
| | - Hideki Onishi
- Department of Psycho‐oncologySaitama Medical University International Medical CenterHidaka CitySaitamaJapan
| |
Collapse
|
4
|
Gomes F, Bergeron G, Bourassa MW, Fischer PR. Thiamine deficiency unrelated to alcohol consumption in high-income countries: a literature review. Ann N Y Acad Sci 2021; 1498:46-56. [PMID: 33576090 PMCID: PMC8451800 DOI: 10.1111/nyas.14569] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Thiamine deficiency has been typically associated with alcoholism or as a prevalent problem in low‐ and middle‐income countries (LMICs) whose populations rely on staple foods with a low content of thiamine. We conducted a literature review of published and unpublished data to identify relevant adult cases with confirmed thiamine deficiency of nonalcoholic cause in developed countries. We selected 17 reports with 81 adult cases of confirmed thiamine deficiency affecting adult patients with a wide range of ages and underlying conditions (e.g., cancer, gastrointestinal diseases, heart failure, and obesity). Thiamine deficiency may have been caused by disease‐related malnutrition, bariatric surgery, chronic use of diuretics, repeated vomiting, lack of thiamine in parenteral nutrition formulas, food insecurity, and reliance on monotonous or restrictive diets. Treatment with intravenous thiamine resulted in partial or complete recovery from the symptoms (cardiac, neurologic, and metabolic disorders) for most patients. The number and variety of symptomatic thiamine‐deficient adults identified in this review demonstrates that thiamine deficiency is not exclusive to LMICs and, in high‐income settings, is not exclusive to alcoholic patients. In developed countries, this serious but treatable condition can be expected in patients suffering from various medical conditions or following certain dietary patterns.
Collapse
Affiliation(s)
| | | | | | - Philip R Fischer
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| |
Collapse
|
5
|
Thiamine Deficiency Causes Long-Lasting Neurobehavioral Deficits in Mice. Brain Sci 2020; 10:brainsci10080565. [PMID: 32824629 PMCID: PMC7464042 DOI: 10.3390/brainsci10080565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/06/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022] Open
Abstract
Thiamine deficiency (TD) has detrimental effects on brain health and neurobehavioral development, and it is associated with many aging-related neurological disorders. To facilitate TD-related neuropsychological studies, we generated a TD mouse model by feeding a thiamine-deficient diet for 30 days, followed by re-feeding the control diet for either one week or 16 weeks as recovery treatment. We then performed neurobehavioral tests in these two cohorts: cohort of one week post TD treatment (1 wk-PTDT) and 16 weeks post TD treatment (16 wks-PTDT). The TD mice showed no significant difference from control in any tests in the 1 wk-PTDT cohort at the age of 13-14 weeks. The tests for the 16 wks-PTDT cohort at the age of 28-29 weeks, however, demonstrated anxiety and reduced locomotion in TD animals in open field and elevated plus maze. In comparison, rotor rod and water maze revealed no differences between TD and control mice. The current findings of the differential effects of the same TD treatment on locomotion and anxiety at different ages may reflect the progressive and moderate change of TD-induced neurobehavioral effects. The study suggests that, even though the immediate neurobehavioral impact of TD is modest or negligible at a young age, the impact could develop and become severe during the aging process.
Collapse
|
6
|
Abdul-Muneer PM, Alikunju S, Schuetz H, Szlachetka AM, Ma X, Haorah J. Impairment of Thiamine Transport at the GUT-BBB-AXIS Contributes to Wernicke’s Encephalopathy. Mol Neurobiol 2017; 55:5937-5950. [DOI: 10.1007/s12035-017-0811-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/20/2017] [Indexed: 12/25/2022]
|
7
|
Tsao WC, Ro LS, Chen CM, Chang HS, Kuo HC. Non-alcoholic Wernicke's encephalopathy with cortical involvement and polyneuropathy following gastrectomy. Metab Brain Dis 2017; 32:1649-1657. [PMID: 28660359 DOI: 10.1007/s11011-017-0055-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/16/2017] [Indexed: 11/25/2022]
Abstract
In this study, we present the clinical manifestations, brain magnetic resonance imaging (MRI) and concurrent polyneuropathies in two patients with non-alcoholic Wernicke's encephalopathy (WE) after gastrojejunostomy (Billroth II) anastomosis procedures. These patients developed sub-acute onset of disorientation and disturbance of consciousness following several weeks of poor intake. Peripheral neuropathy of varying severity was noted before and after the onset of WE. Brain MRI of the patients showed cerebellar vermis and symmetric cortical abnormalities in addition to typical WE changes. Electrophysiological studies demonstrated axonal sensorimotor polyneuropathy. Prompt thiamine supplement therapy was initiated and both patients gradually recovered, however mild amnesia was still noted 6 months later. We reviewed non- alcoholic WE with atypical cortical abnormalities in English language literatures and identified 29 more cases. Eight out of 31 (25.8%) patients died during follow-up. Nine patients with gait disturbance or motor paresis had showed hyporeflexia in neurological examinations. In addition to classic triad, seizure was recorded in seven patients. Dietary deprivation is a risk factor for non-alcoholic WE among elderly patients receiving gastrointestinal surgery. The prognosis is good after thiamine supplement therapy. Recognizing the MRI features and predisposing factors in patients who have undergone gastrectomy can aid in the diagnosis and management.
Collapse
Affiliation(s)
- Wei-Chia Tsao
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Long-Sun Ro
- Section of Neuromuscular Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, 5 Fuhsing Street, Kueishan, Taoyuan, Taiwan
| | - Chiung-Mei Chen
- Section of Neuromuscular Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, 5 Fuhsing Street, Kueishan, Taoyuan, Taiwan
| | - Hong-Shiu Chang
- Section of Neuromuscular Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, 5 Fuhsing Street, Kueishan, Taoyuan, Taiwan
| | - Hung-Chou Kuo
- Section of Neuromuscular Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, 5 Fuhsing Street, Kueishan, Taoyuan, Taiwan.
| |
Collapse
|
8
|
Koike H, Nakamura T, Ikeda S, Takahashi M, Kawagashira Y, Iijima M, Katsuno M, Sobue G. Alcoholic Myelopathy and Nutritional Deficiency. Intern Med 2017; 56:105-108. [PMID: 28049986 PMCID: PMC5313434 DOI: 10.2169/internalmedicine.56.7364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/20/2016] [Indexed: 12/30/2022] Open
Abstract
A patient with chronic alcoholism presented with myelopathy and low serum folate and cobalamin levels. A 42-year-old alcoholic man had gait disturbance for 4 months. A neurological examination revealed marked spasticity with increased deep tendon reflexes and extensor plantar responses of the lower limbs. His cobalamin level was decreased and his serum folate level was particularly low. His plasma ammonia level was not increased. Abstinence and folic acid and cobalamin supplementation stopped the progression of his neurological deficits. This case indicates that nutritional deficiency should be monitored closely in patients with chronic alcoholism who present with myelopathy.
Collapse
Affiliation(s)
- Haruki Koike
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Thiamine Deficiency and Neurodegeneration: the Interplay Among Oxidative Stress, Endoplasmic Reticulum Stress, and Autophagy. Mol Neurobiol 2016; 54:5440-5448. [PMID: 27596507 DOI: 10.1007/s12035-016-0079-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/23/2016] [Indexed: 12/12/2022]
Abstract
Thiamine (vitamin B1) is an essential nutrient and indispensable for normal growth and development of the organism due to its multilateral participation in key biochemical and physiological processes. Humans must obtain thiamine from their diet since it is synthesized only in bacteria, fungi, and plants. Thiamine deficiency (TD) can result from inadequate intake, increased requirement, excessive deletion, and chronic alcohol consumption. TD affects multiple organ systems, including the cardiovascular, muscular, gastrointestinal, and central and peripheral nervous systems. In the brain, TD causes a cascade of events including mild impairment of oxidative metabolism, neuroinflammation, and neurodegeneration, which are commonly observed in neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD). Thiamine metabolites may serve as promising biomarkers for neurodegenerative diseases, and thiamine supplementations exhibit therapeutic potential for patients of some neurodegenerative diseases. Experimental TD has been used to model aging-related neurodegenerative diseases. However, to date, the cellular and molecular mechanisms underlying TD-induced neurodegeneration are not clear. Recent research evidence indicates that TD causes oxidative stress, endoplasmic reticulum (ER) stress, and autophagy in the brain, which are known to contribute to the pathogenesis of various neurodegenerative diseases. In this review, we discuss the role of oxidative stress, ER stress, and autophagy in TD-mediated neurodegeneration. We propose that it is the interplay of oxidative stress, ER stress, and autophagy that contributes to TD-mediated neurodegeneration.
Collapse
|
10
|
Sechi G, Sechi E, Fois C, Kumar N. Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutr Rev 2016; 74:281-300. [PMID: 27034475 DOI: 10.1093/nutrit/nuv107] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
B vitamin deficiency is a leading cause of neurological impairment and disability throughout the world. Multiple B vitamin deficiencies often coexist, and thus an understanding of the complex relationships between the different biochemical pathways regulated in the brain by these vitamins may facilitate prompter diagnosis and improved treatment. Particular populations at risk for multiple B vitamin deficiencies include the elderly, people with alcoholism, patients with heart failure, patients with recent obesity surgery, and vegetarians/vegans. Recently, new clinical settings that predispose individuals to B vitamin deficiency have been highlighted. Moreover, other data indicate a possible pathogenetic role of subclinical chronic B vitamin deficiency in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. In light of these findings, this review examines the clinical manifestations of B vitamin deficiency and the effect of B vitamin deficiency on the adult nervous system. The interrelationships of multiple B vitamin deficiencies are emphasized, along with the clinical phenotypes related to B vitamin deficiencies. Recent advances in the clinical determinants and diagnostic clues of B vitamin deficiency, as well as the suggested therapies for B vitamin disorders, are described.
Collapse
Affiliation(s)
- GianPietro Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
| | - Elia Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Chiara Fois
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Neeraj Kumar
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
11
|
Costantini A, Trevi E, Pala MI, Fancellu R. Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1? Neural Regen Res 2016; 11:1487-1491. [PMID: 27857755 PMCID: PMC5090854 DOI: 10.4103/1673-5374.191225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Myotonic dystrophy type 1, also known as Steinert's disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine (vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and peripheral nervous system, as well as in the muscular cells. Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study. We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months. We evaluated the patients using the grading of muscle strength according to Medical Research Council (MRC), the Muscular Impairment Rating Scale (MIRS), and the Modified Barthel index. High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology, particularly the muscle strength evaluated with the MRC scale, and the patients' activities of daily living using the Modified Barthel Index. At the end of treatment, the MRC score was 5 in the proximal muscles and 2-4 in the distal muscles (the MRC score before the treatment was 3-4 and 1-3, respectively). The MIRS grade improved by 25% compared to baseline for both patients. In patient #1, the Modified Barthel Index improved by 44%, and in patient #2 by 29%. These findings suggest that clinical outcomes are improved by long-term thiamine treatment.
Collapse
Affiliation(s)
- Antonio Costantini
- Department of Neurological Rehabilitation, "Villa Immacolata" Clinic, Viterbo, Italy; School of Physiotherapy, Catholic University of Rome, Rome, Italy
| | - Erika Trevi
- Department of Neurological Rehabilitation, "Villa Immacolata" Clinic, Viterbo, Italy
| | - Maria Immacolata Pala
- Department of Neurological Rehabilitation, "Villa Immacolata" Clinic, Viterbo, Italy
| | - Roberto Fancellu
- Neurology Unit, IRCCS San Martino University Hospital IST, Genoa, Italy
| |
Collapse
|
12
|
Shoshin beriberi induced by long-term administration of diuretics: a case report. Case Rep Cardiol 2014; 2014:878915. [PMID: 25105030 PMCID: PMC4106092 DOI: 10.1155/2014/878915] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 06/21/2014] [Indexed: 11/22/2022] Open
Abstract
Previous studies have suggested that diuretic therapy for heart failure may lead to thiamine deficiency due to the increased urinary thiamine excretion. Herein, we present the case of a 61-year-old man with shoshin beriberi, a fulminant form of wet beriberi, induced by long-term diuretic therapy. The patient had a history of heart failure with preserved ejection fraction and was receiving furosemide and trichlormethiazide therapy. He presented with worsening exertional dyspnea and was admitted for heart failure exacerbation. His condition failed to improve even after intensive treatment. A hemodynamic evaluation with the Swan-Ganz catheter revealed high-output heart failure with low peripheral vascular resistance. Thiamine was administered for suspected shoshin beriberi; his hemodynamic status improved dramatically within the next six hours. The serum thiamine level was below the normal range; the patient was therefore diagnosed with shoshin beriberi. The common causes of thiamine deficiency were not identified. Long-term diuretic therapy with furosemide and thiazide was thought to have played a major role in the development of thiamine deficiency. This case illustrates the importance of considering wet beriberi as a possible cause of heart failure exacerbation in patients taking diuretics, even when the common thiamine deficiency causes are not identified with history-taking.
Collapse
|
13
|
Roman-Campos D, Cruz JS. Current aspects of thiamine deficiency on heart function. Life Sci 2014; 98:1-5. [PMID: 24398040 DOI: 10.1016/j.lfs.2013.12.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/12/2013] [Accepted: 12/18/2013] [Indexed: 12/13/2022]
Abstract
Beriberi is a disease caused by thiamine deficiency (TD), which may lead to heart problems, including heart failure. Despite the fact that thiamine prevalence is reduced in the industrialized world, it remains a health hazard especially due to chronic alcohol consumption. Diagnosing the presence of TD based on both electrocardiogram and echocardiogram exams is particularly challenging because of its non-specific symptoms. TD diagnosis is unique, which then leads to determination of its severity. If thiamine infusion abrogates its symptomology, only then can the case be definitely diagnosed as TD. Another condition eliciting increased likelihood of developing TD in humans is furosemide administration to heart failure patients. Furosemide administration worsens heart failure due to heightened TD. However, literature data provided are contradictory and require clarification. Up until now, the rat has been the preferred TD animal model. However, the results are even more contradictory than those in humans. It seems that if the rat TD models are separated into two distinct groups, according to animal age, the results appear to be more consistent: younger rats are more prone to develop TD signs similar to those found in humans. Their symptoms stem from changes in cardiac myocyte function that are reversed after thiamine supplementation. However, it remains an open question as to why only younger rats are able to develop human-like symptoms and deserve further investigation.
Collapse
Affiliation(s)
- Danilo Roman-Campos
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Jader Santos Cruz
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
14
|
Park JH, Kwon DH, Starling RC, Marwick TH. Role of imaging in the detection of reversible cardiomyopathy. J Cardiovasc Ultrasound 2013; 21:45-55. [PMID: 23837113 PMCID: PMC3701778 DOI: 10.4250/jcu.2013.21.2.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/14/2013] [Accepted: 05/22/2013] [Indexed: 12/19/2022] Open
Abstract
Heart failure is a major clinical problem in developed countries with about half of heart failure patients exhibiting decreased left ventricular systolic function. The correct identification and prompt treatment of some specific etiologies can reverse heart failure, and recognition of myocardial recovery may avoid long-term therapy. However, the echocardiographic patterns of patients with a variety of etiologies of heart failure are similar, so the selective use of other imaging techniques is necessary for identification of specific etiologies. The role of repeat imaging in monitoring the therapeutic response is controversial, as is the cessation of medical therapy in patients demonstrating recovery.
Collapse
Affiliation(s)
- Jae-Hyeong Park
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Oh, USA. ; Cardiology Division of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | | | | | | |
Collapse
|
15
|
Kyriakides T, Angelini C, Schaefer J, Mongini T, Siciliano G, Sacconi S, Joseph J, Burgunder JM, Bindoff LA, Vissing J, de Visser M, Hilton-Jones D. EFNS review on the role of muscle biopsy in the investigation of myalgia. Eur J Neurol 2013; 20:997-1005. [DOI: 10.1111/ene.12174] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 02/14/2013] [Indexed: 12/21/2022]
Affiliation(s)
- T. Kyriakides
- Clinical Neurosciences; Cyprus Institute of Neurology and Genetics; Nicosia Cyprus
| | - C. Angelini
- IRCCS Fondazione Ospedale San Camillo; Venezia Italy
| | - J. Schaefer
- Department of Neurology; University of Dresden; Dresden Germany
| | - T. Mongini
- Neuromuscular Center; S.G. Battista Hospital; University of Turin; Turin Italy
| | - G. Siciliano
- Department of Neuroscience; Neurological Clinic; University of Pisa; Pisa Italy
| | - S. Sacconi
- Centre de reference des Maladies nueuromusculaires; CNRS UMR6543; Nice University Hospital; Nice France
| | - J. Joseph
- St George's University of London at the University of Nicosia Medical School; Nicosia Cyprus
| | - J. M. Burgunder
- Departments of Neurology and Clinical Research; University of Bern; Inselspital; Bern Switzerland
| | - L. A. Bindoff
- Department of Neurology; Haukeland University Hospital; Bergen Norway
| | - J. Vissing
- Neuromuscular Clinic and Research Unit; Department of Neurology; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - M. de Visser
- Department of Neurology; Academic Medical Center; Amsterdam The Netherlands
| | - D. Hilton-Jones
- Oxford Neuromuscular Centre; Department of Neurology; John Radcliffe Hospital; Oxford UK
| |
Collapse
|
16
|
Becker DA, Ingala EE, Martinez-Lage M, Price RS, Galetta SL. Dry Beriberi and Wernicke’s encephalopathy following gastric lap band surgery. J Clin Neurosci 2012; 19:1050-2. [DOI: 10.1016/j.jocn.2011.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 11/10/2011] [Indexed: 11/16/2022]
|
17
|
Chen X, Green PG, Levine JD. Neuropathic pain-like alterations in muscle nociceptor function associated with vibration-induced muscle pain. Pain 2010; 151:460-466. [PMID: 20800357 DOI: 10.1016/j.pain.2010.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 08/03/2010] [Accepted: 08/04/2010] [Indexed: 11/26/2022]
Abstract
We recently developed a rodent model of the painful muscle disorders induced by occupational exposure to vibration. In the present study we used this model to evaluate the function of sensory neurons innervating the vibration-exposed gastrocnemius muscle. Activity of 74 vibration-exposed and 40 control nociceptors, with mechanical receptive fields in the gastrocnemius muscle, were recorded. In vibration-exposed rats ∼15% of nociceptors demonstrated an intense and long-lasting barrage of action potentials in response to sustained suprathreshold mechanical stimulation (average of 2635 action potentials with frequency of ∼44Hz during a 1min suprathreshold stimulus) much greater than that has been reported to be produced even by potent inflammatory mediators. While these high-firing nociceptors had lower mechanical thresholds than the remaining nociceptors, exposure to vibration had no effect on conduction velocity and did not induce spontaneous activity. Hyperactivity was not observed in any of 19 neurons from vibration-exposed rats pretreated with intrathecal antisense for the IL-6 receptor subunit gp130. Since vibration can injure peripheral nerves and IL-6 has been implicated in painful peripheral neuropathies, we suggest that the dramatic change in sensory neuron function and development of muscles pain, induced by exposure to vibration, reflects a neuropathic muscle pain syndrome.
Collapse
Affiliation(s)
- Xiaojie Chen
- Department Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA 94143, USA Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | | | | |
Collapse
|
18
|
Koike H, Ito S, Morozumi S, Kawagashira Y, Iijima M, Hattori N, Tanaka F, Sobue G. Rapidly developing weakness mimicking Guillain-Barré syndrome in beriberi neuropathy: two case reports. Nutrition 2008; 24:776-80. [PMID: 18440777 DOI: 10.1016/j.nut.2008.02.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 02/13/2008] [Accepted: 02/22/2008] [Indexed: 01/19/2023]
Abstract
OBJECTIVE We examined the diagnostic difficulty in thiamine deficiency. METHODS We report on two patients with polyneuropathy associated with thiamine deficiency (i.e., beriberi neuropathy) that presented with acute motor symptoms mimicking Guillain-Barré syndrome. RESULTS The cause of the thiamine deficiency was associated with gastrectomy to treat cancer in a 46-y-old man and with dietary imbalance in a 33-y-old man. The thiamine deficiency was not related to alcohol intake in either patient. In both patients, the upper and lower extremities showed a rapidly progressive weakness over the course of 1 mo. Muscle weakness in the first patient progressed even after admission to the hospital, and urinary retention, Wernicke's encephalopathy, lactic acidosis, paralytic ileus, and heart failure appeared subsequently. Clinical symptoms in both patients showed improvement after initiation of thiamine administration, although some residual deficit remained. CONCLUSION Thiamine deficiency must be actively considered as a possible cause of polyneuropathy, and variability in its clinical features should be taken into consideration.
Collapse
Affiliation(s)
- Haruki Koike
- Department of Neurology, Nagoya University School of Medicine, Nagoya, Japan
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Williams FH. Neuromuscular Complications of Nutritional Deficiencies. Phys Med Rehabil Clin N Am 2008; 19:125-48, vii. [DOI: 10.1016/j.pmr.2007.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|