What is the clinical presentation associated with thiamine deficiency and what are the risk factors?

Bottom line: Known risk factors for thiamine deficiency include alcohol use, old age, eating disorders, diuretic use, bariatric surgery, dialysis, HIV infection, radical diets.

Summary: Entry for thiamine deficiency in DynaMed Plus.
Lists risk factors that include various conditions affecting nutrition, such as history of bariatric surgery. Also see the history and physical section.

Singh S, Kumar A. Wernicke encephalopathy after obesity surgery: a systematic review. Neurology. 2007 Mar 13;68(11):807-11.
Review of reports on Wernicke encephalopathy after bariatric surgery. Of the 32 cases identified in the literature, 21 presented with the triad of confusion, ataxia and nystagmus. Discusses presence/absence of thiamine supplementation after surgery in these cases.

Recent case report (NEJM. 2012;367: 67-72) indicates that this condition in patients with a recent history of gastric bypass continues to pose a diagnostic challenge.


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Clinical Informationist at EUH Branch Library
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