Choque cardiogénico e hiperlactacidemia en una paciente con Shoshin Beriberi, en un hospital general de Lima, Perú. Reporte de caso

• Zegarra Piérola, Jaime Wilfredo ^[1] ; Cornejo Valdivia , Carla Cornejo Valdivia ^[2] ; Sante Farfán , Giancarlo ^[2] ; Callo Rodrigo, Diana ^[2] ; Lévano Díaz, Lady ^[2] ; Sotelo Olivera, María ^[2] ; Beramendi Torres, Yessenia ^[2] ; Mezones Vega, Melisa ^[1]
  1. [1] Universidad Peruana Cayetano Heredia

     Universidad Peruana Cayetano Heredia

     Perú

     
  2. [2] Hospital Nacional Cayetano Heredia

     Hospital Nacional Cayetano Heredia

     Perú

     
• Localización: Revista Médica Herediana, ISSN-e 1729-214X, ISSN 1018-130X, Vol. 35, Nº. 4 (Octubre-Diciembre), 2024, págs. 224-230
• Idioma: español
• Títulos paralelos:
  • Cardiogenic shock and hyperlactatemia in a patient with Shoshin Beriberi in a general hospital in Lima, Peru. A case report
• Enlaces
  • Texto completo
• Resumen
  • español

    El Shoshin Beriberi es una enfermedad generada por la deficiencia de tiamina y se caracteriza por disfunción cardiaca aguda fulminante. Se presenta el caso de una mujer de 22 años, con historia de anorexia nerviosa, tuberculosis multisistémica; con dolor abdominal, vómitos, intolerancia oral, ayuno prolongado, recibió nutrición parenteral total sin aporte de tiamina y estuvo hospitalizada 40 días en sala de hospitalización general. Ingreso a la unidad de cuidados intensivos (UCI) en choque cardiogénico e hiperlactacidemia con, lactato sérico 13,8 mmol/l, sin evidencia de sepsis, de evento vascular agudo y con choque cardiogénico refractario al uso de noradrenalina, vasopresina y dobutamina, se consideró el diagnóstico de Shoshin beriberi y se administró 300 mg de tiamina endovenoso, con rápida respuesta, logrando la estabilización hemodinámica y cardiopulmonar, con posterior alta de UCI y del hospital.

  • English

    Introduction: Shoshin Beriberi is a disease generated by thiamine deficiency and is characterized by acute fulminant cardiac dysfunction (1). Objective: To highlight cardiogenic shock and hyperlactacidemia in a patient with shoshin beriberi in an intensive care unit of a general hospital. Material and method: The information was taken from the electronic medical history of the intensive care unit (ICU) of the Cayetano Heredia National Hospital (HNCH) and from laboratory and image records. Case: 22-year-old female patient, with a history of anorexia nervosa, multisystem tuberculosis (TBC); with abdominal pain, vomiting, oral intolerance, prolonged fasting, received total parenteral nutrition (TPN) without thiamine intake and with hospitalization for 40 days on the general floor; Admission to the ICU in cardiogenic shock and hyperlactacidemia with serum lactate 13.8 mmol/L. With sepsis ruled out, an acute vascular event and cardiogenic shock refractory to the use of norepinephrine, vasopressin and dobutamine, the diagnosis of shoshin beriberi was considered and 300 mg of intravenous thiamine was administered, with a rapid response, achieving hemodynamic and cardiopulmonary stabilization, with subsequent discharge from ICU and hospital. Conclusion: Cardiogenic shock and hyperlactacidemia were manifestations of shoshin beriberi, with sepsis and acute vascular event ruled out and with the use of thiamine hemodynamic and cardiopulmonary stabilization was achieved.

    Keywords: cardiogenic shock, hyperlactacidemia, shoshin beriberi, thiamine