{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:47:56Z","timestamp":1772131676077,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: vitamin B1 level depletion, known as a beriberi syndrome, can lead to severe cardiovascular complications, from which perimyocarditis fulminans is one of the most severe. (2) Methods: this is a retrospective case study that includes an adult patient with clinical presentations of acute heart failure (HF) symptoms following perimyocarditis on the grounds of thiamine deficiency. (3) Results: A 49-year-old woman presented with acute HF symptoms due to perimyocarditis. The patient suddenly developed refractory cardiogenic shock with metabolic acidosis requiring maximal medical management, including an intra-aortic balloon pump and extracorporeal membrane oxygenation. Due to additional peripheral polyneuropathy, beriberi disease was suspected after excluding other possible causes of the patient\u2019s condition. After administration of vitamin B1, clinical improvement in the patient\u2019s condition and the resolution of metabolic abnormalities were observed, which ultimately confirmed the diagnosis of Shoshin syndrome caused by the implementation of a gluten-free diet without indications for its adherence. (4) Conclusions: Fulminant beriberi disease, although considered rare, is a life-threatening condition and should always be included in the differential diagnosis of critically ill patients, notably those with malnutrition. An unbalanced diet can be detrimental and have severe consequences, i.e., perimyocarditis fulminans. However, treatment with thiamine can significantly improve the patient\u2019s cardiac function and restore hemodynamic and metabolic parameters.<\/jats:p>","DOI":"10.3390\/life13010205","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T02:06:03Z","timestamp":1673402763000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Vitamin B1 Deficiency and Perimyocarditis Fulminans: A Case Study of Shoshin Syndrome in a Woman Following an Unbalanced Dietary Pattern Followed by a Literature Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Justyna","family":"Rohun","sequence":"first","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5226-8311","authenticated-orcid":false,"given":"Karolina","family":"Dorniak","sequence":"additional","affiliation":[{"name":"Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"M\u0142odzi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Witold","family":"Bachorski","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Grucha\u0142a","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Raczak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2269-1880","authenticated-orcid":false,"given":"Ludmi\u0142a","family":"Dani\u0142owicz-Szymanowicz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hrub\u0161a, M., Siatka, T., Nejmanov\u00e1, I., Vopr\u0161alov\u00e1, M., Kujovsk\u00e1 Kr\u010dmov\u00e1, L., Matou\u0161ov\u00e1, K., Javorsk\u00e1, L., Mac\u00e1kov\u00e1, K., Mercolini, L., and Remi\u00e3o, F. (2022). Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5. Nutrients, 14.","DOI":"10.3390\/nu14030484"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/ecam\/nek009","article-title":"A review of the biochemistry, metabolism and clinical benefits of thiamin(e) and its derivatives","volume":"3","author":"Lonsdale","year":"2006","journal-title":"Evid. Based Complement. Alternat. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10741-014-9432-0","article-title":"Thiamin deficiency and heart failure: The current knowledge and gaps in literature","volume":"20","author":"Ahmed","year":"2015","journal-title":"Heart Fail Rev."},{"key":"ref_4","first-page":"21","article-title":"Beri-Beri heart disease","volume":"95","author":"Gubbay","year":"1966","journal-title":"Can. Med. Assoc. J."},{"key":"ref_5","first-page":"e1","article-title":"A case of shoshin beriberi presenting as cardiogenic shock with diffuse ST-segment elevation, which dramatically improved after a single dose of thiamine","volume":"25","author":"Kim","year":"2014","journal-title":"Cardiovasc. J. Afr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1161\/01.CIR.58.3.566","article-title":"Fulminant beriberi heart disease with lactic acidosis: Presentation of a case with evaluation of left ventricular function and review of pathophysiologic mechanisms","volume":"8","author":"Attas","year":"1978","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.ijcard.2016.07.248","article-title":"An unusual case of cardiogenic shock in which thiamine administration led to reversal of lactic acidosis and heart function recovery: Shoshin beriberi in an adolescent","volume":"222","author":"Cottini","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1007\/s00134-005-2648-7","article-title":"A patient with severe lactic acidosis and rapidly evolving multiple organ failure: A case of shoshin beri-beri","volume":"31","author":"Kountchev","year":"2005","journal-title":"Intensive Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12937-015-0039-7","article-title":"Shoshin Beriberi in Critically-Ill patients: Case series","volume":"14","author":"Dabar","year":"2015","journal-title":"Nutr. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1746-1596-6-8","article-title":"Cardiac beriberi: Morphological findings in two fatal cases","volume":"6","author":"Bello","year":"2011","journal-title":"Diagn. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/BF00292932","article-title":"Shoshin beriberi: An underdiagnosed condition?","volume":"12","author":"Pang","year":"1986","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5603\/CJ.a2013.0059","article-title":"Impaired global and segmental myocardial deformation assessed by two-dimensional speckle tracking echocardiography in patients with vitamin B12 deficiency","volume":"21","author":"Kaya","year":"2014","journal-title":"Cardiol. J."},{"key":"ref_13","first-page":"82","article-title":"Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients","volume":"14","author":"Niland","year":"2018","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_14","first-page":"2438934","article-title":"A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis","volume":"2019","author":"Olenick","year":"2019","journal-title":"J. Nutr. Metab."},{"key":"ref_15","first-page":"636","article-title":"Giant T inversion in cardiac beriberi","volume":"58","author":"Hathirat","year":"1975","journal-title":"J. Med. Assoc. Thail."},{"key":"ref_16","first-page":"1115","article-title":"Shoshin beriberi. A rapidly curable hemodynamic disaster","volume":"25","author":"Meurin","year":"1996","journal-title":"Presse Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/nyas.13919","article-title":"Thiamine deficiency disorders: Diagnosis, prevalence, and a roadmap for global control programs","volume":"1430","author":"Whitfield","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/nyas.14536","article-title":"Thiamine deficiency disorders: A clinical perspective","volume":"1498","author":"Smith","year":"2021","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e0010","DOI":"10.1097\/MD.0000000000010010","article-title":"Wet beriberi with multiple organ failure remarkably reversed by thiamine administration: A case report and literature review","volume":"97","author":"Lei","year":"2018","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Barennes, H., Sengkhamyong, K., Rene, J.P., and Phimmasane, M. (2015). Beriberi (thiamine deficiency) and high infant mortality in northern Laos. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003581"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ihj.2016.07.015","article-title":"Shoshin beriberi-thiamine responsive pulmonary hypertension in exclusively breastfed infants: A study from northern India","volume":"69","author":"Bhat","year":"2017","journal-title":"Indian Heart J."},{"key":"ref_22","first-page":"1871","article-title":"Lactic acidosis treated with thiamine. 3 cases","volume":"14","author":"Thomas","year":"1985","journal-title":"Presse Med."},{"key":"ref_23","first-page":"195","article-title":"Shoshin syndrome: Two case reports representing opposite ends of the same disease spectrum","volume":"53","author":"Shivalkar","year":"1998","journal-title":"Acta Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"503","DOI":"10.4103\/1947-2714.102003","article-title":"Clinical correlates and outcome of shoshin beriberi","volume":"4","author":"Saya","year":"2012","journal-title":"N. Am. J. Med. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1177\/0148607114568316","article-title":"Thiamine Deficiency in a Developed Country: Acute Lactic Acidosis in Two Neonates Due to Unsupplemented Parenteral Nutrition","volume":"40","author":"Salvatori","year":"2016","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref_26","first-page":"2005","article-title":"Shoshin beriberi with hyponatremia in a beer drinker","volume":"15","author":"Delorme","year":"1986","journal-title":"Presse Med."},{"key":"ref_27","first-page":"546","article-title":"Acute pernicious beriberi in a patient receiving parenteral nutrition. A case report","volume":"75","author":"Naidoo","year":"1989","journal-title":"S. Afr. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1002\/clc.4960151113","article-title":"Shoshin beriberi in an AIDS patient with end-stage renal disease","volume":"15","author":"Cage","year":"1992","journal-title":"Clin. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1651-2227.1992.tb12346.x","article-title":"Shoshin beriberi in an infant of a thiamine-deficient mother","volume":"81","author":"Debuse","year":"1992","journal-title":"Acta Paediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/j.1442-200X.1992.tb00988.x","article-title":"Cardiac beriberi (shoshin beriberi) caused by excessive intake of isotonic drink","volume":"34","author":"Fujita","year":"1992","journal-title":"Acta Paediatr. Jpn."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0736-4679(98)00040-7","article-title":"Severe acidosis and hyperdynamic circulation in a 39-year-old alcoholic","volume":"16","author":"Smith","year":"1998","journal-title":"J. Emerg. Med."},{"key":"ref_32","first-page":"331","article-title":"Acute cardiovascular beriberi (shoshin-beriberi)","volume":"62","author":"Malvino","year":"2002","journal-title":"Medicina"},{"key":"ref_33","first-page":"1601","article-title":"Shoshin beriberi provoked by the inhalation of salbutamol","volume":"147","author":"Groeneveld","year":"2003","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"ref_34","first-page":"361","article-title":"Shoshin beriberi complicating severe pulmonary hypertension: A case report","volume":"49","author":"Goto","year":"2007","journal-title":"J. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1093\/qjmed\/hcp095","article-title":"A case of ST-elevation and nystagmus\u2014When coronary thrombosis is not to blame","volume":"102","author":"Daly","year":"2009","journal-title":"QJM Int. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s12519-010-0022-5","article-title":"Shoshin beriberi mimicking central line sepsis in a child with short bowel syndrome","volume":"6","author":"Greenspon","year":"2010","journal-title":"World J. Pediatr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1016\/j.jemermed.2008.03.040","article-title":"Shoshin beriberi mimicking a high-risk non-ST-segment elevation acute coronary syndrome with cardiogenic shock: When the arteries are not guilty","volume":"41","author":"Doltra","year":"2011","journal-title":"J. Emerg. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1024\/1661-8157\/a000567","article-title":"Alcohol, acid, vitamins and heart","volume":"100","author":"Reinhardt","year":"2011","journal-title":"Praxis"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.psym.2012.01.010","article-title":"A case of Shoshin Beriberi: Lessons old and new for the psychiatrist","volume":"54","author":"Brown","year":"2013","journal-title":"Psychosomatics."},{"key":"ref_40","first-page":"506072","article-title":"Clinical history and colliquative myocytolysis are keys to the diagnosis of shoshin beriberi","volume":"2014","author":"Kuno","year":"2014","journal-title":"Case Rep. Pathol."},{"key":"ref_41","first-page":"878915","article-title":"Shoshin beriberi induced by long-term administration of diuretics: A case report","volume":"2014","author":"Misumida","year":"2014","journal-title":"Case Rep. Pathol."},{"key":"ref_42","first-page":"392","article-title":"Thiamine deficiency in infants: A case report","volume":"21","author":"Moulin","year":"2014","journal-title":"Arch. Pediatr. Organe Off. Soc. Fr. Pediatr."},{"key":"ref_43","first-page":"S66","article-title":"Acute dilated cardiomyopathy in a patient with beriberi and cryoglobulinaemic vasculitis: An unusual potential complication of two rare disorders","volume":"32","author":"Tejedor","year":"2014","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1536\/ihj.15-033","article-title":"Shoshin Beriberi With Low Cardiac Output and Hemodynamic Deterioration Treated Dramatically by Thiamine Administration","volume":"56","author":"Imamura","year":"2015","journal-title":"Int. Heart J."},{"key":"ref_45","first-page":"5043818","article-title":"Beriberi Induced Cardiomyopathy Requiring Salvage Venoarterial Extracorporeal Membrane Oxygenation","volume":"2016","author":"Shah","year":"2016","journal-title":"Case Rep. Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e13493","DOI":"10.1111\/petr.13493","article-title":"Acute Shoshin beriberi syndrome immediately post-kidney transplant with rapid recovery after thiamine administration","volume":"23","author":"Elias","year":"2019","journal-title":"Pediatr. Transplant."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3389\/fped.2019.00119","article-title":"Shoshin Beriberi and Severe Accidental Hypothermia as Causes of Heart Failure in a 6-Year-Old Child: A Case Report and Brief Review of Literature","volume":"7","author":"Vicinanza","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_48","first-page":"307","article-title":"Severe Lactic Acidosis in a Critically Ill Child: Think About Thiamine! A Case Report","volume":"10","author":"Didisheim","year":"2020","journal-title":"J. Pediatr. Intensive Care"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.jdcr.2020.02.031","article-title":"Shoshin beriberi in a patient with oral and cutaneous graft-versus-host disease","volume":"6","author":"Hodgkinson","year":"2020","journal-title":"JAAD Case Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e670","DOI":"10.7861\/clinmed.2021-0550","article-title":"Lessons of the month 1: Shoshin beriberi: A case report of fulminant cardiovascular collapse, intractable hyperlactatemia and deteriorating consciousness","volume":"21","author":"Lim","year":"2021","journal-title":"Clin. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2905","DOI":"10.2169\/internalmedicine.8697-21","article-title":"Cardiac Dysfunction Due to Thiamine Deficiency after Hemodialysis for Biguanide-related Lactic Acidosis","volume":"61","author":"Tamaki","year":"2022","journal-title":"Intern. Med."},{"key":"ref_52","first-page":"624","article-title":"Shoshin beriberi and thiamine-responsive right heart failure: A case report in Mayotte Recognition and management of infant Shoshin beriberi","volume":"29","author":"Nguyen","year":"2022","journal-title":"Arch. Pediatr. Organe Off. Soc. Fr. Pediatr."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/205\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:06:07Z","timestamp":1760119567000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["life13010205"],"URL":"https:\/\/doi.org\/10.3390\/life13010205","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]}}}