Abstract
Often thought to be a nutritional issue limited to low‐ and middle‐income countries (LMICs), pediatric thiamine deficiency (PTD) is perceived as being eradicated or anecdotal in high‐income countries (HICs). In HICs, classic beriberi cases in breastfed infants by thiamine‐deficient mothers living in disadvantaged socioeconomic conditions are thought to be rare. This study aims to assess PTD in HICs in the 21st century. Literature searches were conducted to identify case reports of PTD observed in HICs and published between 2000 and 2020. The analyzed variables were age, country, underlying conditions, clinical manifestations of PTD, and response to thiamine supplementation. One hundred and ten articles were identified, totaling 389 PTD cases that were classified into four age groups: neonates, infants, children, and adolescents. Eleven categories of PTD‐predisposing factors were identified, including genetic causes, lifestyle (diabetes, obesity, and excessive consumption of sweetened beverages), eating disorders, cancer, gastrointestinal disorders/surgeries, critical illness, and artificial nutrition. TD‐associated hyperlactatemia and Wernicke encephalopathy were the most frequent clinical manifestations. The circumstances surrounding PTD in HICs differ from classic PTD observed in LMICs and this study delineates its mutiple predisposing factors. Further studies are required to estimate its magnitude. Awareness is of utmost importance in clinical practice.
Highlights
Thiamine, called vitamin B1 or aneurin, is a water-soluble vitamin that is an essential micronutrient for human beings, who cannot synthesize it and whose body reserves in tissues can be depleted within a couple of weeks without adequate thiamine intake.[1]
While the major cause of classic diet thiamine deprivation is no longer relevant in 2020 in high-income countries (HICs), this study has revealed a small but noticeable number of pediatric thiamine deficiency (PTD) cases arising from critical illnesses or chronic conditions that are managed in highly specialized pediatric services
There is a clear shift toward older children as opposed to young infants, as seen in low- and middle-income countries (LMICs)
Summary
Called vitamin B1 or aneurin, is a water-soluble vitamin that is an essential micronutrient for human beings, who cannot synthesize it and whose body reserves in tissues can be depleted within a couple of weeks without adequate thiamine intake.[1]. Thiamine is involved in many processes, in energy transformation and oxidative and nonoxidative carbohydrate metabolism. As a crucial cofactor in the metabolism of carbohydrates and amino acids, its role is extended to fatty acid metabolism.[1,2] The limited body storage in tissues, combined with low intake, contributes to the propensity to thiamine deficiency (TD) during all life stages of human beings.
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