Anaphylaxis thiamine

Fernandez M, Barcelo M, Munoz C, Torrecillas M, Blanca M. Anaphylaxis to thiamine (vitamin Bl). Allergy 1997 52(9) 958-60. 

Morinville V, Jeannet-Peter N, Hauser C. Anaphylaxis to parenteral thiamine (vitamin Bl). Schweiz Med Wochenschr 1998 128(44) 1743-4. 

Johri S, Shetty S, Soni A, Kumar S. Anaphylaxis from intravenous thiamine—long forgotten Am J Emerg Med 2000 18(5) 642-3. 

Adverse reactions Pyridoxine Occasional Stinging at IM injection site Rare headache, nausea, somnolence high doses cause sensory neuropathy (paresthesia, unstable gait, clumsiness of hands) Thiamine Rare anaphylaxis after a large IV dose Riboflavin None known... 

As there are no reports of adverse effects from consumption of excess thiamine from food and supplements (supplements of 50 mg/day are widely available without prescription), and the data are inadequate for a quantitative risk assessment, no UL has been defined for thiamine. However, as stimulators of transketolase enzyme synthesis such as thiamine support a high rate of nucleic acid ribose synthesis necessary for tumor cell survival, chemotherapy resistance, and proliferation, some concern has been expressed that thiamine supplementation of common food products may contribute to increased cancer rates in the Western world. There is, however, littie evidence to support this assumption. Rarely, individuals given high-dose intravenous thiamine in treatment of beriberi have developed anaphylaxis, the frequency being about 1 100,000. 

I Vitamins (thiamin (Bi), B complex) as alcoholics are likely to be vitamin (especially thiamine) deficient due to poor diet and poor absorption. Parenteral thiamine preferable as poorly absorbed orally (caution as anaphylaxis is a rare but recognised... 

Adverse reactions Thiamine rare anaphylaxis after a large IV dose Riboflavin none known Niacin or nicotinic acid Cardiac arrythmias may occur rarely Pyridoxine Lxmg-term megadoses may produce sensory neuropathy... 

WE is caused by acute thiamine (Vitamin B ) deficiency - ejq)lain the risks and prescribe high potency B vitamins ITable 40.41. Pabrinex triggers anaphylaxis extremely rarely, but ensure adrenaline 0.5 mg IM is prescribed and available. 

Immune Anaphylaxis with cardiac arrest secondary to intravenous thiamine administration has been described [23 ]. 

The authors concluded that while the present use of thiamine is still recommended, clinicians should be aware of the symptoms of anaphylaxis as simple treatment could be lifesaving when initiated early. 

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