A 4-month-old exclusively breastfed infant presents with tachycardia, cardiomegaly, and a weak aphonic cry. The mother reports the family consumes only highly polished rice with almost no pulses or animal foods. Which deficiency is the most likely cause?

• A Niacin
• B Pyridoxine
• C Riboflavin
• D Thiamine ✓

Explanation

Infantile beriberi occurs in breastfed infants of thiamine-deficient mothers, typically those subsisting on polished rice. Cardiac beriberi presents with high-output cardiac failure, tachycardia, cardiomegaly, and the characteristic aphonic cry; it responds dramatically to parenteral thiamine. Niacin deficiency produces pellagra with dermatitis, diarrhoea and dementia, a picture not seen in early infancy, which eliminates the strongest distractor.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.