A 4-month-old exclusively breastfed infant whose mother eats mainly polished rice presents with tachycardia, tachypnea, hepatomegaly and a weak, almost voiceless cry. Chest X-ray shows cardiomegaly. There is no fever and blood culture is sterile. Symptoms begin to reverse within hours of an intramuscular injection of which vitamin?
- A Thiamine ✓
- B Pyridoxine
- C Riboflavin
- D Ascorbic acid
Correct answer: A. Thiamine
Explanation
This is infantile beriberi due to maternal thiamine deficiency; mothers subsisting on polished rice transmit thiamine-poor milk. Cardiac beriberi presents with high output failure, tachycardia, cardiomegaly and the characteristic aphonic or hoarse cry. Rapid improvement after parenteral thiamine is diagnostic. Pyridoxine deficiency causes seizures rather than heart failure, and riboflavin deficiency causes angular stomatitis and glossitis without cardiomyopathy.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.