Thiamine deficiency may be seen in all of the following except: March 2009
Correct Answer: Homocystinemia
Description: Ans. A: Homocystinemia Causes of thiamine deficiency: Lack of thiamine intake : - Diets consisting mainly of the following: Food containing a high level of thiaminases, including milled rice, raw freshwater fish, raw shellfish, and ferns Food high in anti-thiamine factor, such as tea, coffee, and betel nuts Processed food with a content high in sulfite, which destroys thiamine - Alcoholic state - Starvation state Increased consumption states - Diets high in carbohydrate or saturated fat intake - Pregnancy - Hypehyroidism - Lactation - Fever - severe infection - Increased physical exercise Increased depletion - Diarrhea - Diuretic therapies - Peritoneal dialysis - Hemodialysis - Hyperemesis gravidarum Loss of thiamine through renal excretion can occur with most, if not all, diuretics. It has been seen with the use of such diuretics as mannitol, acetazolamide, chlorothiazide, amiloride, and loop diuretics. Thiamine loss is associated with the increase in urine flow rate, but it is not related to sodium excretion. This suggests that patients with polyuria, even if the condition is unrelated to diuretics, may benefit from thiamine supplementation.
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