A young man from a poor socio economic family presented with symmetric distal peripheral neuropathy involving both sensory and motor systems along with features of congestive hea failure. Investigations revealed thiamine deficiency. All of the following conditions are predisposing factors for thiamine deficiency, EXCEPT:
Correct Answer: Homocysteinemia
Description: Thiamine deficiency is now most often seen as a consequence of chronic alcohol abuse, recurrent vomiting, total parenteral nutrition, and bariatric surgery. Thiamine deficiency polyneuropathy can occur in normal, healthy young adults who do not abuse alcohol but who engage in inappropriately restrictive diets. clinical thiamine deficiency is limited primarily to alcoholics, food faddists, and patients receiving chemotherapy. Predisposing factors for pediatric thiamine deficiency include unsupplemented parenteral nutrition, breastfed infants of thiamine-deficient mothers, congestive hea failure,85 and severe malnutrition. Ref: Amato A.A., Barohn R.J. (2012). Chapter 384. Peripheral Neuropathy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
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