Peripheral neuropathy and cardiac beriberi due to vitamin B1 deficiency in a patient 6 years after proximal gastrectomy : A case report

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  • Haruta Hidenori
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Hosoya Yoshinori
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Kurashina Kentaro
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Ui Takashi
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Saito Shin
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Zuiki Toru
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Matsumoto Shiro
    Department of Neurology, Jichi Medical University
  • Sata Naohiro
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University
  • Yasuda Yoshikazu
    Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University

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Other Title
  • 噴門側胃切除術後6 年目に発症した脚気ニューロパチー，衝心脚気の1 例

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Abstract

Herein we report on a case of peripheral neuropathy and cardiac beriberi due to vitamin B1 deficiency after gastrectomy.<br>A 58-year-old man underwent proximal gastrectomy with jejunal pouch interposition for gastric cancer. Although the patient ate a balanced diet after surgery, postoperative computed tomography and endoscopic examinations revealed food stasis in the jejunal pouch. Six years after initial surgery, the patient complained of muscle weakness, unusual sensations in his distal lower extremities, edema in both legs, and of being easily fatigued. He developed lactic acidosis, followed by acute cardiac failure, resulting in shock. The patient's blood vitamin B1 level was 10 ng/mL (normal range 20-50 ng/mL). The patient's symptoms improved markedly after intravenous infusion of vitamin B1. Cardiac beriberi is a serious condition ; thus, it is important to consider vitamin B1 deficiency in patients, even long after proximal gastrectomy with jejunal pouch interposition and food stasis in the jejunal pouch.

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