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Title: Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi
Authors: Douangdao Soukaloun
Sue J. Lee
Karen Chamberlain
Ann M. Taylor
Mayfong Mayxay
Kongkham Sisouk
Bandit Soumphonphakdy
Khaysy Latsavong
Kongsin Akkhavong
Douangkham Phommachanh
Vanmaly Sengmeuang
Khonsavanh Luangxay
Theresa McDonagh
Nicholas J. White
Paul N. Newton
Mahosot Hospital
Nuffield Department of Clinical Medicine
Mahidol University
MRC Human Nutrition Research
University of Health Sciences
Royal Brompton Hospital
Keywords: Medicine
Issue Date: 1-Feb-2011
Citation: PLoS Neglected Tropical Diseases. Vol.5, No.2 (2011)
Abstract: Background:Infantile beriberi is a potentially lethal manifestation of thiamin deficiency, associated with traditional post-partum maternal food avoidance, which persists in the Lao PDR (Laos). There are few data on biochemical markers of infantile thiamin deficiency or indices of cardiac dysfunction as potential surrogate markers.Methodology/Principal Findings:A case control study of 47 infants with beriberi and age-matched afebrile and febrile controls was conducted in Vientiane, Laos. Basal and activated erythrocyte transketolase activities (ETK) and activation (α) coefficients were assayed along with plasma brain natriuretic peptide, N-terminal pro-brain natriuretic peptide and troponin T. Basal ETK (and to a lesser extent activated ETK) and plasma troponin T were the only infant biochemical markers that predicted infantile beriberi. A basal ETK≤0.59 micromoles/min/gHb gave a sensitivity (95%CI) of 75.0 (47.6 to 92.7)% and specificity (95%CI) of 85.2 (66.3 to 95.8)% for predicting infantile beriberi (OR (95%CI) 15.9 (2.03-124.2); p = 0.008) (area under ROC curve = 0.80). In contrast, the α coefficient did not discriminate between cases and controls. Maternal basal ETK was linearly correlated with infant basal ETK (Pearson's r = 0.66, p < 0.001). The odds of beriberi in infants with detectable plasma troponin T was 3.4 times higher in comparison to infants without detectable troponin T (OR 3.4, 95%C I 1.22-9.73, p = 0.019). Detectable troponin T had a sensitivity (95%CI) of 78.6 (59.0 to 91.7) % and specificity (95%CI) of 56.1 (39.7 to 71.5) % for predicting infantile beriberi.Conclusions/Significance:Basal ETK is a more accurate biochemical marker of infantile beriberi than the activation coefficient. Raised plasma troponin T may be a useful indicator of infantile beriberi in infants at risk and in the absence of other evident causes. © 2011 Soukaloun et al.
Appears in Collections:Scopus 2011-2015

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