title: Rapidly developing weakness mimicking Guillain-Barré syndrome in beriberi neuropathy: two case reports.
abstract: OBJECTIVE
  We examined the diagnostic difficulty in thiamine deficiency.
  
  
  METHODS
  We report on two patients with polyneuropathy associated with thiamine deficiency (i.e., beriberi neuropathy) that presented with acute motor symptoms mimicking Guillain-Barré syndrome.
  
  
  RESULTS
  The cause of the thiamine deficiency was associated with gastrectomy to treat cancer in a 46-y-old man and with dietary imbalance in a 33-y-old man. The thiamine deficiency was not related to alcohol intake in either patient. In both patients, the upper and lower extremities showed a rapidly progressive weakness over the course of 1 mo. Muscle weakness in the first patient progressed even after admission to the hospital, and urinary retention, Wernicke's encephalopathy, lactic acidosis, paralytic ileus, and heart failure appeared subsequently. Clinical symptoms in both patients showed improvement after initiation of thiamine administration, although some residual deficit remained.
  
  
  CONCLUSIONS
  Thiamine deficiency must be actively considered as a possible cause of polyneuropathy, and variability in its clinical features should be taken into consideration.
authors.affiliation: Department of Neurology, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Koike
authors.forename: Shinji
authors.initials: S
authors.lastname: Ito
authors.forename: Saori
authors.initials: S
authors.lastname: Morozumi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kawagashira
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iijima
authors.forename: Naoki
authors.initials: N
authors.lastname: Hattori
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Tanaka
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
mesh_terms: D000328:Adult; D001602:Beriberi / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005743:Gastrectomy / Q000009:adverse effects; D020275:Guillain-Barre Syndrome / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011115:Polyneuropathies / Q000175:diagnosis* / Q000209:etiology; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D013831:Thiamine