Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Rapidly progressive polyneuropathy due to dry beriberi in a man: a case report | Howard et al. Journal of Medical Case Reports 2010 4 409 http content 4 1 409 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Rapidly progressive polyneuropathy due to dry beriberi in a man a case report Anthony J Howard1 Omesh Kulkarni1 Godwin Lekwuwa2 Hedley CA Emsley1 Abstract Introduction We describe a case of rapidly progressive and severely debilitating polyneuropathy in a patient with confirmed hypovitaminosis B1 consistent with dry beriberi. Crucially this is a treatable condition although sometimes with incomplete recovery but it is probably under-recognized yet increasingly common given increasing levels of alcohol abuse in the western world. Case presentation A 49-year-old Caucasian British man presented with progressive weakness of both lower limbs of approximately seven months duration. He noted difficulty climbing stairs. He also complained of lethargy and loss of muscle bulk including his thighs. He had a history of type 2 diabetes mellitus and admitted prior alcohol abuse but denied excessive alcohol intake in the five years prior to presentation. Initial clinical and neurophysiological examinations were consistent with a mild peripheral neuropathy and probable proximal myopathy. However over the subsequent four months he evolved a marked tetraparesis with profound sensory disturbance of all limbs. Repeat neurophysiology revealed a widespread polyneuropathy with extensive acute and sub-acute denervation changes in all four limbs and reduced or absent sensory nerve action potentials. Hypovitaminosis B1 was confirmed 45 nmol L reference range 66-200 nmol L . His rapid clinical deterioration was in keeping with dry beriberi. He was treated with thiamine. Subsequent follow-up revealed slow but significant improvement such that by 15-16 months from the initial onset of symptoms and approximately six months after the onset of his marked tetraparesis he was able to stand independently and was gradually gaining confidence
