Pulmonary artery catheter usage in diagnosis of Shoshin beriberi presented with unexplained lactic acidosis

Wet beriberi is a rare but fatal disease in modern society. The nonspecific clinical manifestations, including symptoms of heart failure and recalcitrant lactic acidosis, can prevent timely diagnosis. The use of a pulmonary artery catheter can promptly confirm a high cardiac output state and plays a crucial role in rapidly deteriorating cases. Appropriate treatment with intravenous administration of thiamine leads to dramatic recovery within hours. We present two cases of Shoshin beriberi, a fulminant variant of wet beriberi, diagnosed in 2016 and 2022 at our institute. The patients experienced haemodynamic collapse and refractory lactic acidosis, which were successfully diagnosed with the use of a pulmonary artery catheter and reversed by thiamine supplementation. We also reviewed 19 cases of wet beriberi reported between 2010 and 2022.

Automated summary

Wet beriberi, a rare but fatal disease, can present with nonspecific clinical manifestations and delay timely diagnosis. The use of a pulmonary artery catheter is crucial in rapidly deteriorating cases to confirm high cardiac output state. Prompt intravenous thiamine administration leads to dramatic recovery. Two cases of Shoshin beriberi were diagnosed in 2016 and 2022, both successfully reversed by thiamine supplementation through the use of a pulmonary artery catheter. A review of 19 wet beriberi cases reported between 2010 and 2022 was also conducted.