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Thiamine deficiency
From WikEM
Contents
Background
- Most common cause: chronic alcohol abuse
- Other causes: malabsorption, hemodialysis, chronic protein-calorie undernutrition
- IV dextrose can precipitate in patients with marginal thiamine stores
Clinical Features
- Early/mild features:
- Anorexia
- Muscle cramps
- Paresthesias
- Irritability
- Advanced/severe deficiency
- See [[beriberi
- See Wernicke-Korsakoff syndrome
Differential Diagnosis
- Ethanol toxicity
- Alcohol withdrawal
- Electrolyte/acid-base disorder
Vitamin deficiencies
- Vitamin A deficiency
- Vitamin B deficiencies
- Vitamin B1 deficiency (Thiamine)
- Vitamin B3 deficiency (Pellagra)
- Vitamin B9 deficiency (Folate)
- Vitamin B7 deficiency (Biotin)
- Vitamin B12 deficiency
- Vitamin C deficiency (Scurvy)
- Vitamin D deficiency (Rickets)
- Vitamin E deficiency
- Vitamin K deficiency
Evaluation
- Clinical diagnosis
Management
- Thiamine 50–100 mg IV for first few days, followed by 5-10mg PO daily
- Replete other vitamins/electrolytes that may also be depleted (e.g. banana bag, magnesium, folate, multivitamin)
- Replete thiamine before giving IV dextrose!
See Also
Thiamine deficiency
Authors
Claire, Matthew Hankerson, Ross Donaldson, Amr Badawy, Daniel Ostermayer
