Postgastrectomy polyneuropathy with thiamine deficiency is identical to beriberi neuropathy.
OBJECTIVE
We assessed whether postgastrectomy polyneuropathy associated with thiamine deficiency is clinicopathologically identical to beriberi neuropathy, including a biochemical determination of thiamine status.


METHODS
Clinicopathologic features of 17 patients who had postgastrectomy polyneuropathy with thiamine deficiency were compared with those of 11 patients who had thiamine-deficiency neuropathy caused by dietary imbalance.


RESULTS
The typical presentation for the two etiologies was as a symmetric sensorimotor polyneuropathy predominantly involving the lower limbs. A variety of clinical features, including neuropathic symptoms, progression, and coexistence of heart failure or Wernicke's encephalopathy, was seen similarly in both conditions. In both groups, the main electrophysiologic findings were those of axonal neuropathy, most prominently in the lower limbs. Sural nerve biopsy specimens also indicated axonal degeneration in both groups. Subperineurial edema was commonly observed.


CONCLUSIONS
This study showed that thiamine-deficiency neuropathies due to gastrectomy and dietary imbalance are identical despite variability in their clinicopathologic features and suggested that thiamine deficiency can be a major cause of postgastrectomy polyneuropathy.
Koike
Haruki
H
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Iijima
Masahiro
M
Mori
Keiko
K
Hattori
Naoki
N
Ito
Hiroki
H
Hirayama
Masaaki
M
Sobue
Gen
G
D001602:Beriberi / Q000150:complications*; D004594:Electrophysiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011115:Polyneuropathies / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications; D013831:Thiamine / Q000008:administration & dosage* / Q000627:therapeutic use; D013832:Thiamine Deficiency / Q000150:complications*
D013831:Thiamine