Vitamin B1 (Thiamine), anti beri-beri vitamin
It is heat labile.
Active form of thiamine - TPP (thiamine pyrophosphate).
It contain pyrimidine ring attach to thiazola ring.
Daily requirement for children
Infant; 0.2- 0.5 mg/day
Children; 0.5-1mg/day
Function
1. Important role in carbohydrate metabolism
2. Required for maintaining Nerves
3. Essential for functioning of coenzymes
Clinical manifestations of deficiency
1. Beri- beri
Types of beri- beri are;
1. Dry beri-beri
Diminished abdominal reflex.
Wasting of muscle, muscle pain and tenderness
Burning feet Syndrome
Difficulty in rising from squatting position (bending knee)
2. Wet beri-beri
Generalized oedema (anasarca)
Cardiac enlargement
Palpitation
3. Infantile beri-beri
Occurs mainly in infants breastfed by mother with inadequate intake of thiamine.
4. Cerebral beri-beri
a. Wernicke's - korsakoff's Syndrome
(Degenerative brain disorder caused by lack of thiamine. Symptoms are;
Foot drop
Wrist drop
Ataxia of gait
Derangement of mental functions
Confusion and apthy (lack of emotion)
5. Polyneuritis beri-beri
Paralysis and loss of reflexes
Diagnostic Evaluation
1. Blood or urine examination
2. Erythrocyte transketolase (measuring activity of transketolase in RBCs).
Loss of appetite
Muscle weakness
Gait ataxia; uncoordinated muscle
Parasthesias; abnormal sensation
Wernicke's encephalopathy
Nystagmus; involuntary eye movement
Ataxia
Confusion
Sensory loss
Difficulty Breathing
Congestive heart failure
Chronic passive congestion in viscera (obstruction in normal flux of blood within blood vessel).
Management
1. Thiamine supplement (orally)
2. Thiamine injection; intramuscular (IM) or slow IV.
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