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肠道手术后继发硫胺素缺乏导致急性暴发性脚气病和韦尼克脑病:一例报告

Thiamine deficiency secondary to intestinal surgery leading to shoshin beriberi and Wernicke encephalopathy: a case report.

作者信息

Huang Peiyu, Chen Junyu, Deng Zhixuan, Yang Weiguo

机构信息

Department of Pediatric Intensive Care Unit, Shenzhen Children's Hospital, Shenzhen, China.

Hengyang Medical School, Institute of Cell Biology, University of South China, Hengyang, Hunan, China.

出版信息

Front Pediatr. 2025 May 26;13:1576805. doi: 10.3389/fped.2025.1576805. eCollection 2025.

Abstract

PURPOSE

Thiamine is an essential micronutrient, and its deficiency, also known as beriberi, can have significant clinical implications. Thiamine deficiency impairs oxidative metabolic pathways, leading to reduced adenosine triphosphate (ATP) synthesis and energy production. This deficiency primarily affects energy-demanding organs, such as the brain and heart, resulting in central and peripheral neuropathies, severe metabolic acidosis, or even circulatory failure. Due to its nonspecific clinical presentation, thiamine deficiency is often misdiagnosed or overlooked, making early recognition and intervention critical for improving outcomes.

CASE REPORT

This report describes a case of shoshin beriberi with concurrent neurological involvement caused by thiamine deficiency following intestinal surgery. Remarkably, the patient's condition improved significantly with timely thiamine supplementation.

CONCLUSION

In individuals at high risk of thiamine deficiency, such as those with prolonged fasting, gastrointestinal disorders, or chronic malnutrition, early identification and timely intervention are crucial for improving prognosis and reducing mortality. Early recognition and treatment are critical to reducing mortality associated with this condition.

摘要

目的

硫胺素是一种必需的微量营养素,其缺乏症,也称为脚气病,可能具有重大的临床意义。硫胺素缺乏会损害氧化代谢途径,导致三磷酸腺苷(ATP)合成减少和能量产生降低。这种缺乏主要影响对能量需求较高的器官,如大脑和心脏,导致中枢和周围神经病变、严重代谢性酸中毒,甚至循环衰竭。由于其临床表现不具特异性,硫胺素缺乏症常被误诊或忽视,因此早期识别和干预对于改善预后至关重要。

病例报告

本报告描述了一例因肠道手术后硫胺素缺乏导致的干性脚气病并发神经受累的病例。值得注意的是,患者通过及时补充硫胺素,病情显著改善。

结论

在硫胺素缺乏高危人群中,如长期禁食、患有胃肠道疾病或慢性营养不良的人群,早期识别和及时干预对于改善预后和降低死亡率至关重要。早期识别和治疗对于降低与此病症相关的死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd65/12146283/0d8d1c2b65a0/fped-13-1576805-g001.jpg

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