Djoenaidi W, Notermans S L, Dunda G
Department of Neurology, Airlangga University, Faculty of Medicine, Dr Soetomo Hospital, Surabaya, Indonesia.
Eur J Clin Nutr. 1992 Mar;46(3):227-34.
In Indonesia beriberi is still endemic, but subclinical cases are not uncommon. Three patients suffering from beriberi presented with different clinical manifestations. One had the classical features of Shoshin beriberi and the other two had the non-alcoholic cardiac beriberi (chronic type). The cardiac symptoms of all three patients responded dramatically to thiamine tetrahydrofurfuryl disulfide; there was also some improvement of their polyneuropathy, consistent with the neurophysiologic findings and somatosensory evoked potentials (SSEPs). We conclude that SSEPs provide additional clinical information on beriberi polyneuropathy. The mortality of untreated cardiovascular beriberi is high. In view of the harmless nature of the treatment, a good case could be made for routine administration of thiamine to all patients in whom heart failure is present without clear evidence of the cause.
在印度尼西亚，脚气病仍然是地方病，但亚临床病例并不罕见。三名患有脚气病的患者表现出不同的临床表现。一名患者具有典型的暴发性脚气病特征，另外两名患有非酒精性心脏脚气病（慢性型）。所有三名患者的心脏症状对硫胺四氢糠基二硫化物均有显著反应；他们的多发性神经病也有一定改善，这与神经生理学发现和体感诱发电位（SSEPs）一致。我们得出结论，体感诱发电位为脚气病多发性神经病提供了额外的临床信息。未经治疗的心血管型脚气病死亡率很高。鉴于治疗方法无害，可以为所有存在心力衰竭但无明确病因证据的患者常规使用硫胺提出充分理由。
