title: [An Uncommon Diagnosis].
abstract: We report on a 61-year-old patient who suffered from severe protein-energy malnutrition due to an inadequately treated exocrine pancreatic insufficiency. In this context, a thiamine deficiency was not recognized and there were clinical manifestations of beriberi disease with decompensated biventricular heart failure. In the course of time, a manifest niacin deficiency (pellagra) with dermatitis, diarrhea and persistent delirium occurred, which was recognized and could be treated. We highlight differential diagnostic considerations about the consequences and the treatment of malnutrition, with special focus on the classical deficiency diseases beriberi and pellagra.
authors.affiliation: 1 Universitätsklinik für Endokrinologie, Diabetologie und Klinische Ernährung, Inselspital Bern.
authors.forename: Nicole
authors.initials: N
authors.lastname: Leonhard
authors.affiliation: 2 Universitätsklinik für Allgemeine Innere Medizin, Universitätsspital, Inselspital Bern.
authors.forename: Carla
authors.initials: C
authors.lastname: Aeberhard
authors.affiliation: 2 Universitätsklinik für Allgemeine Innere Medizin, Universitätsspital, Inselspital Bern.
authors.forename: Tanja
authors.initials: T
authors.lastname: Birrenbach
authors.affiliation: 1 Universitätsklinik für Endokrinologie, Diabetologie und Klinische Ernährung, Inselspital Bern.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Stanga
mesh_terms: D001602:Beriberi / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D010383:Pellagra / Q000175:diagnosis* / Q000209:etiology*; D011502:Protein-Energy Malnutrition / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*
keywords: Beriberi; Mangelernährung; Niacinmangel; Pellagra; Thiaminmangel; beriberi; malnutrition; niacin deficiency; pellagra; thiamine deficiency