Acute respiratory failure in an infant and thiamine deficiency in West Africa: a case report
Acute respiratory failure in an infant and thiamine deficiency in West Africa: a case report
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DOI：
10.1093/omcr/omaa041
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发表时间：
2020-06-01
影响因子：
0.5
通讯作者：
Janet, S.
中科院分区：
文献类型：
--
作者：
Hiffler, L.;Escajadillo, K.;Janet, S.
在儿科，硫胺素缺乏症（TD）的整体临床表现不容易识别，因为它类似于其他疾病，甚至在典型的脚气病病例中也可能与其他疾病混淆。不出所料，在没有脚气病描述的地方，误诊TD的可能性更大。危重病人体内硫胺素消耗增加，葡萄糖基静脉输液进一步增加硫胺素细胞需求。因此，严重的急性疾病可能导致TD，或在硫胺素处于临界状态的患者中引发TD症状，并带来危及生命的后果。在这里，我们描述了一个年轻的病人入院西非医院的TD没有很好的记录和诊断为严重的肺炎谁对硫胺素注射反应显著。由于缺乏快速诊断能力和TD的严重后果，有理由在临床高度怀疑的病例中使用治疗性硫胺素注射。提高对TD和低硫胺素使用阈值的认识应该指导临床医生的实践。
In paediatrics, the overall clinical picture of thiamine deficiency (TD) is not easy to recognize, because it mimics or can be confused with other diseases even in cases of classic beriberi. Unsurprisingly, the likelihood of misdiagnosis of TD is even greater where beriberi has not been described.Critically ill patients have increased thiamine body consumption and dextrose-based IV fluid increases thiamine cellular demand even further. Consequently, severe acute conditions may result in TD, or trigger TD signs in patients with borderline thiamine status, with life-threatening consequences.Here, we describe the case of a young patient admitted to a West African hospital where TD is not well documented and diagnosed with severe pneumonia who responded dramatically to thiamine injection.The lack of rapid diagnostic capacity and the severe outcome of TD justify the use of a therapeutic thiamine challenge in cases with high clinical suspicion. Increased awareness about TD and low threshold for thiamine use should guide clinicians in their practice.