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11-SEPTEMBER-2008 12:20:15 - Beriberi The references used in this article may be clearer with a different or consistent style of citation, footnoting, or external linking. Beriberi Classification and external resources A sufferer - Turn of the 20th century in southeast Asia ICD-10 E51.1 ICD-9 265.0 DiseasesDB 14107 eMedicine ped/229 med/221 MeSH D001602 Beriberi pronounced Berry-berry is a nervous system ailment caused by thiamine vitamin B1 deficiency. Thiamine is needed to help convert carbohydrates into glucose. Symptoms include severe lethargy and fatigue, together with complications affecting the cardiovascular, nervous, muscular, and gastrointestinal systems. Contents 1 Etymology 2 Causes 3 Symptoms and effects 4 Treatment 5 History 6 References 6.1 Footnotes 6.2 General references 7 External links 8 See also Etymology The origin of the word is from a Sinhalese phrase meaning I cannot, I cannot, the word being doubled for emphasis.1 Causes Beriberi is caused by a lack of thiamine vitamin B1. Thiamine occurs naturally in unrefined cereals and fresh foods, particularly whole grain bread, fresh meat, legumes, green vegetables, fruit, and milk. Beriberi is therefore common in people whose diet excludes these particular types of nutrition. Beriberi may be found in people whose diet consists mainly of polished white rice, which is very low in thiamine because the thiamine-bearing husk has been removed. It can also be seen in chronic alcoholics with an inadequate diet Wernicke-Korsakoff syndrome, as well as being a rare side effect of gastric bypass surgery. If a baby is mainly fed on the milk of a mother who suffers from thiamine deficiency then that child may develop beriberi as well. The disease was often found in Asian countries especially in the 19th century and before, due to those countries' reliance on white rice as a staple food. Symptoms and effects Its symptoms 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. It may also increase the amount of lactic acid and pyruvic acid within the blood. 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 edematous. Dry beriberi causes wasting and partial paralysis resulting from damaged peripheral nerves. It is also referred to as endemic neuritis. Treatment Treatment for beriberi is with thiamine hydrochloride, either in tablet form or injection. A rapid and dramatic recovery within hours can be made when this is administered to patients, and their health can be improved within an hour of starting treatment. In emergency situations where concentrated thiamine supplements are unavailable, feeding the patient with a thiamine-rich diet e.g. whole grain brown bread will lead to recovery, though at a much slower rate. Additionally, administering glucose will provide the patient with a temporary boost, while their body recovers. History In Asia where polished white rice was the common staple food of the middle class, beriberi resulting from lack of vitamin B was endemic. In 1884, Takaki Kanehiro, a British-trained Japanese medical doctor of the Japanese Navy observed that beriberi was endemic among low ranking crew who often ate nothing but rice but not among crews of Western navies and officers who were entitled to a Western-style diet. Kanehiro initially believed that lack of protein was the chief cause of beriberi. With the support of Japanese navy, he experimented using crews of two battleships, one crew was fed only white rice, while the other was fed a diet of meat, fish, barley, rice, and beans. The group that ate only white rice documented 161 crew with beriberi and 25 deaths, while the latter group had only 14 cases of beriberi and no deaths. This convinced Kanehiro and the Japanese Navy that diet was the cause of beriberi. This was confirmed in 1897, when Christiaan Eijkman discovered that feeding unpolished rice instead of the polished variety to chickens helped to prevent beriberi in the chickens. The following year, Frederick Hopkins postulated that some foods contained accessory factors-in addition to proteins, carbohydrates, fats, et cetera-that were necessary for the functions of the human body.2 Christiaan Eijkman, a Dutch physician and pathologist, demonstrated that beriberi is caused by poor diet. His work led to the discovery of vitamins. Together with Sir Frederick Hopkins, he was awarded the 1929 Nobel Prize for Physiology or Medicine for the discovery. References Footnotes ^ Beriberi, Information about Beriberi ^ Jack Challem 1997. The Past, Present and Future of Vitamins General references Angstadt JD, Bodziner RA 2005. Peripheral polyneuropathy from thiamine deficiency following laparoscopic Roux-en-Y gastric bypass. Obes Surg 15 6: 890-2. doi:10.1381/0960892054222759. PMID 15978166. Hawk A 2006. The great disease enemy, Kak'ke beriberi and the Imperial Japanese Army. Mil Med 171 4: 333-9. PMID 16673750. Diagnosing Beriberi in Emergency Situations, by Prof Mike Golden, Aberdeen University. n.d. McIntyre N, Stanley NN 1971. Cardiac beriberi: two modes of presentation. Br Med J 3 5774: 567-9. PMID 5571454. Mouly S, Khuong MA, Cabie A, Saimot AG, Coulad JP 1996. Beri-Beri and thiamine deficiency in HIV infection. AIDS 10 8: 931-2. PMID 8828758. Shivalkar B, Engelmann I, Carp L, De Raedt H, Daelemans R 1998. Shoshin syndrome: two case reports representing opposite ends of the same disease spectrum. Acta Cardiol 53 4: 195-9. PMID 9842404. Jeb Sprague and Eunida Alexandra. Haiti: Mysterious Prison Ailment Traced to U.S. Rice - Inter Press Service IPS. 17 January 2007. Weise Prinzo Z, de Benoist B 2002. Meeting the challenges of micronutrient deficiencies in emergency-affected populations. Proc Nutr Soc 61 2: 251-7. doi:10.1079/PNS2002151. PMID 12133207. External links www.wrongdiagnosis.com : beriberi Medical Encyclopedia, Medline, National Institutes of Health. L Arturo Batres, MD. Beriberi.EMedicine.com See also Edward Bright Vedder v d e Nutrition disorders E40-68, 260-269 Malnutrition Kwashiorkor - Marasmus - Catabolysis Avitaminosis B vitamins: B1: Beriberi/Wernicke's encephalopathy, B2: Ariboflavinosis, B3: Pellagra, B6: Pyridoxine deficiency, B7: Biotin deficiency, B9: Folate deficiency, B12: Vitamin B12 deficiency other vitamins: A: Vitamin A deficiency/Bitot's spots, C: Scurvy, D: Rickets/Osteomalacia Mineral deficiency Zinc deficiency - Iron deficiency - Magnesium deficiency - Chromium deficiency - Keshan disease Hyperalimentation Obesity - Vitamin poisoning Hypervitaminosis A, Hypervitaminosis D, Hypervitaminosis E Retrieved from http://en..org/wiki/Beriberi Categories: Malnutrition | ReduplicantsHidden category: references cleanup Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية БългарÑ?ки Dansk Deutsch Español Esperanto Français Italiano עברית МакедонÑ?ки Nederlands 日本語 ‪Norsk bokmÃ¥l‬ Polski Português РуÑ?Ñ?кий SlovenÅ¡Ä?ina СрпÑ?ки / Srpski Suomi Svenska Tagalog తెలà±?à°—à±? Türkçe УкраїнÑ?ька ä¸æ–‡ This page was last modified on 18 August 2008, at 10:11
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