title: Clinical history and colliquative myocytolysis are keys to the diagnosis of shoshin beriberi.
abstract: Cardiovascular beriberi presents as either the fulminant (Shoshin beriberi) or chronic form. Shoshin beriberi is a rare disease that may lead to a fatal outcome if the patient does not receive appropriate treatment. In the present report, we describe the case of a 66-year-old man presenting with leg edema and dyspnea at rest. Clinical presentations were nonalcoholic Shoshin beriberi and lactate accumulation; however, clinical improvement was observed after the administration of thiamine. His pretherapy thiamine level (2.1  μ g/dL) was consistent with a diagnosis of beriberi. Based on the findings of the present case, we believe that a diagnosis can be made in patients with a clinical history that is consistent with that of Shoshin beriberi, combined with low thiamine levels, lactate accumulation, and colliquative myocytolysis. Learning Objective. Shoshin beriberi is often misdiagnosed because of its rarity; a detailed clinical history and characteristic myocardial histopathology changes may be useful for making a definite diagnosis.
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Toshiki
authors.identifier: 0000-0002-2487-8366
authors.initials: T
authors.lastname: Kuno
authors.affiliation: Department of Community Health and Medicine, School of Medicine, Yamaguchi University, Yamaguchi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Endo
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Hiroyuki
authors.identifier: 0000-0002-0044-1653
authors.initials: H
authors.lastname: Motoda
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Numasawa
authors.affiliation: Department of Clinical Laboratory and Pathology, Ashikaga Red Cross Hospital, Tochigi, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga City, Tochigi 326-0843, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi