Often thought to be a nutritional issue limited to low- and middle-income countries (LMICs), pediatric thiamine deficiency (PTD) is perceived as being eradicated or anecdotal in high-income countries (HICs). In HICs, classic beriberi cases in breastfed infants by thiamine-deficient mothers living in disadvantaged socioeconomic conditions are thought to be rare. This study aims to assess PTD in HICs in the 21st century. Literature searches were conducted to identify case reports of PTD observed in HICs and published between 2000 and 2020. The analyzed variables were age, country, underlying conditions, clinical manifestations of PTD, and response to thiamine supplementation. One hundred and ten articles were identified, totaling 389 PTD cases that were classified into four age groups: neonates, infants, children, and adolescents. Eleven categories of PTD-predisposing factors were identified, including genetic causes, lifestyle (diabetes, obesity, and excessive consumption of sweetened beverages), eating disorders, cancer, gastrointestinal disorders/surgeries, critical illness, and artificial nutrition. TD-associated hyperlactatemia and Wernicke encephalopathy were the most frequent clinical manifestations. The circumstances surrounding PTD in HICs differ from classic PTD observed in LMICs and this study delineates its mutiple predisposing factors. Further studies are required to estimate its magnitude. Awareness is of utmost importance in clinical practice.

中文翻译：

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2000 年至 2020 年高收入国家儿童硫胺素缺乏症：临床重新评估

儿童硫胺素缺乏症 (PTD) 通常被认为是仅限于中低收入国家 (LMIC) 的营养问题，但在高收入国家 (HIC) 中，儿童硫胺素缺乏症 (PTD) 已被根除或已成为传闻。在高收入国家，生活在社会经济条件不利的、缺乏硫胺素的母亲母乳喂养的婴儿中，典型的脚气病病例被认为是罕见的。本研究旨在评估 21 世纪高收入国家的 PTD。我们进行了文献检索，以确定在高收入国家中观察到并在 2000 年至 2020 年间发表的 PTD 病例报告。分析的变量包括年龄、国家、基础疾病、PTD 的临床表现以及对补充硫胺素的反应。共识别出 110 篇文章，总计 389 个 PTD 病例，分为四个年龄组：新生儿、婴儿、儿童和青少年。确定了 11 类 PTD 诱发因素，包括遗传原因、生活方式（糖尿病、肥胖和过量饮用甜饮料）、饮食失调、癌症、胃肠道疾病/手术、危重疾病和人工营养。TD 相关的高乳酸血症和韦尼克脑病是最常见的临床表现。高收入国家中 PTD 的情况与中低收入国家中观察到的典型 PTD 不同，本研究描述了其多种诱发因素。需要进一步的研究来估计其规模。意识在临床实践中至关重要。