Beriberi history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

The symptoms of beriberi are usually vague and therefore, the diagnosis must be considered in the clinical and geographical contexts. Common symptoms for wet beriberi include tachycardia, respiratory distress, and edema, while common symptoms for dry beriberi include parasthesia, muscle pain, weakness.

• The majority of beriberi patients usually have no specific symptoms of beriberi.
• Therefore, detailed history in the clinical and geographical context is valuable in these patients.
• The patient should be asked about his diet regimen, alcohol consumption rate, and any surgeries in the past period.
• Family history may be present in rare cases with genetic beriberi in which a genetic mutation interferes with thiamine absorption.
  

• Cardiovascular or wet beriberi is manifested by cardiac hypertrophy and heart failure with high cardiac output.^[1]
  • Palpitations
  • Respiratory distress
  • Edema of the legs
  • Severe lactic acidosis.

• Neurological or dry beriberi is manifested by polyneuritis (sometimes paralysis) that typically starts in the lower limbs and progresses to the upper limbs,
  • Parathesia
  • Muscle weakness and muscle pain^[2]
  • Convulsions.

• Gastrointestinal symptoms are due to delayed gastric emptying and colon dilation.
  • Loss of appetite,
  • Vague abdominal complaints
  • Constipation
  • Nausea and vomiting in advanced stages.

• Wernicke-korsakoff syndrome:
  • Wernicke’s disease is a triad of nystagmus, ophthalmoplegia, and ataxia, along with confusion.
  • Korsakoff’s psychosis is impaired short-term memory and confabulation with otherwise grossly normal cognition.
  • This combination is almost exclusively described in chronic alcoholics with thiamine deficiency.^[3][4]

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