Beriberi shoshin

Thiamin deficiency can result in three distinct syndromes a chronic peripheral neuritis, beriberi, which may or may not be associated with heart ilure and edema acute pernicious (fulminating) beriberi (shoshin beriberi), in which heart failure and metabolic abnormalities predominate, without peripheral neuritis and Wernicke s encephalopathy with KorsakofPs psychosis, which is associated especially with alcohol and dmg abuse. The central role of thiamin diphosphate in... 

Acute Pernicious (Fulminating) Beriberi - Shoshin Beriberi... 

Acute infantile beriberi in infants breast-fed by deficient mothers may involve high-output cardiac failure, as in shoshin beriberi, as well as signs of central nervous system involvement similar to those seen in Wernicke s encephalopathy (Section 6.4.4). 

Acute pernicious (fulminating) beriberi - shoshin beriberi... 

Like shoshin beriberi, Wernicke s encephalopathy can develop acutely, without the more gradual development of Korsakoff s psychosis, among previously starved patients given intravenous glucose and seriously ill patients given parenteral hyperalimentation. 

Wet Beriberi. The presence of edema distinguishes this form from dry beriberi. Other features are extreme loss of appetite, breathlessness, and disorders of the heart which range from palpitation and rapid heart rate to dilation of the heart muscle (myocardium) and congestive heart failure. When the cardiac disorders are severe, the disease may be called cardiac beriberi, or Shoshin beriberi (a name us in Asia). 

Citreoviridin (79), luteoskyrin (80), and cyclochlorotine (81) are historical mycotoxins studied in Japan. Citreoviridin was isolated as a toxin from Penicillium citreoviride associated with a disease called cardiac beriberi or shoshin kakke .164 Luteoskyrin and cyclochlorotine were isolated from Penicillium islandicum, which was infected into toxic yellowed rice.165 Genes responsible for biosynthesis of these compounds are not obtained. 

Heart failure without increased cardiac output, and no peripheral edema, may also occur acutely, associated with severe lactic acidosis. This was a common presentation of deficiency in Japan, where it was called shoshin (= acute) beriberi in the 1920s, nearly 26,000 deaths a year were recorded. 

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