Acute pernicious or fulminating beriberi heart disease. A report of 6 patients.

OBJECTIVE

To investigate the incidence and presentation of acute pernicious or fulminating beriberi in a general district hospital.

METHODS

All patients with a diagnosis of acute pernicious or fulminating beriberi heart disease made between 1978 and 1994 were identified, and their medical records were retrospectively examined.

RESULTS

Six cases of acute pernicious or fulminating beriberi heart disease were recognized. The disease was characterized by circulatory shock and peripheral cyanosis. All patients had severe lactic acidosis, in 5 of them without hypoxaemia. Four patients were alcoholics. The most important diagnostic criterion was the impressive improvement after thiamine administration.

CONCLUSIONS

Acute pernicious or fulminating beriberi heart disease can be recognized occasionally. Thiamine should be administered as soon as possible in suspected cases.