Wet and dry beriberi are two clinical manifestations of thiamine deficiency, and beriberi with fulminant cardiovascular collapse is called Shoshin beriberi. It can present as shock with high levels of lactate and a need for high doses of vasopressor therapy, in which thiamine infusion can effectuate rapid cardiovascular and respiratory recovery. This is not often considered in the differential diagnosis of profound shock but thiamine deficiency is more prevalent than oftentimes thought, and therefore we present two cases of Shoshin beriberi in our intensive care unit with thiamine-mediated shock reversal. Both patients were malnourished, had demonstrably low thiamine levels, and showed marked recovery upon infusion of thiamine.
Back to issue - Download PDF