Acute neuromyocarditis secondary to diet-associated beriberi: a case report.

Introduction. - Thiamine deficiency can be determined by various clinical s igns; some of these symptoms may be acute, and require an urgent diagnosis. In countries such as ours with a high standard of living, this disorder is more commonly observed in cases of severe alcoholism, and cases of diet-as sociated thiamine deficiency are rare, and therefore not easily recognized. The metabolic disorders resulting from vitamin B-1 deficiency are responsi ble for the well-known central or peripheral neurological-symptoms, and als o for the less common and often more acute cardiovascular reactions. Immedi ate thiamine/vitamin B-1 supplementation is of major importance. The rapid reversal of symptoms following this treatment is often considered as a diag nostic index. Exegesis, - In this study, an original case of diet-associated thiamine def iciency has been reported with clinical symptoms including myocarditis and subacute peripheral nerve involvement in a young adult. The disorder was th e result of a thiamine deficiency in the diet, which was exclusively based on milled rice. Conclusion. - The present report is interesting both as regards its clinica l aspects and its etiology, and it emphasizes the importance in the differe ntial diagnosis of a given case of taking the possibility of diet-related t hiamine deficiency into account, although this is an uncommon etiology in d eveloped countries. (C) 2000 Editions scientifiques et medicales Elsevier S AS.