[Acute neuromyocarditis secondary to diet-induced beriberi. Case report].
BACKGROUND
Thiamine deficiency can be determined by various clinical signs; some of these symptoms may be acute, and require an urgent diagnosis. In countries such as ours with a high standard of living, this disorder is more commonly observed in cases of severe alcoholism, and cases of diet-associated thiamine deficiency are rare, and therefore not easily recognized. The metabolic disorders resulting from vitamin B1 deficiency are responsible for the well-known central or peripheral neurological symptoms, and also for the less common and often more acute cardiovascular reactions. Immediate thiamine/vitamin B1 supplementation is of major importance. The rapid reversal of symptoms following this treatment is often considered as a diagnostic index.


METHODS
In this study, an original case of diet-associated thiamine deficiency has been reported, with clinical symptoms including myocarditis and subacute peripheral nerve involvement in a young adult. The disorder was the result of a thiamine deficiency in the diet, which was exclusively based on milled rice.


CONCLUSIONS
The present report is interesting both as regards its clinical aspects and its etiology, and it emphasizes the importance in the differential diagnosis of a given case of taking the possibility of diet-related thiamine deficiency into account, although this is an uncommon etiology in developed countries.
Ben Ghorbel
I
I
Service de médecine interne, hôpital de la Conception, Marseille, France.
Veit
V
V
Schleinitz
N
N
Kaplanski
G
G
Harlé
J R
JR
D000328:Adult; D001602:Beriberi / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004032:Diet; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000175:diagnosis* / Q000209:etiology; D012275:Oryza; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D013832:Thiamine Deficiency / Q000150:complications*