[Shoshin beriberi provoked by the inhalation of salbutamol]. / Sjosjin-beriberi na inhalatie van salbutamol.

A 45-year-old male alcoholic with a deficient diet was given salbutamol for exertion-related dyspnoea. After inhalation, he presented with a severe dyspnoea, acrocyanosis, anuria and low blood pressure as well as a respiratory compensated lactate acidosis. Shoshin beriberi was suspected on clinical grounds. The low level of thiamine and the prompt recovery after thiamine repletion confirmed this diagnosis. Shoshin beriberi is an acute, cardiac form of beriberi, which can rapidly result in death due to cardiogenic shock and lactate acidosis. Adrenergic agents can cause a hyperdynamic circulation and thus aggravate the effects of a thiamine deficiency.

Cardiac beriberi (shoshin beriberi) caused by excessive intake of isotonic drink.

A 21 month old female had voluntarily ingested 0.5-1.51 of isotonic sports drink daily from 10 months of age. She developed hyponatremia and beriberi heart disease, which resulted in metabolic acidosis and cardiogenic shock (shoshin beriberi). Mechanical ventilation was applied for pulmonary edema. Right heart failure was improved after administering vitamin B1. However, 5 days after the shock, hypoxemia and diffuse radiographic infiltrates progressed, and a diagnosis of adult respiratory distress syndrome (ARDS) was made. After the occurrence of an air leak, the patient died of respiratory failure. The cardiogenic shock and pulmonary edema due to cardiac beriberi may have triggered the ARDS.

[Danger to human health from mycotoxins]. / Gefährdung der menschlichen Gesundheit durch Mykotoxine

The review paper summarizes our knowledge on the influence of the intake of mycotoxin containing foodstuffs on human health. The greatest attention is given to the aflatoxins. The results of epidemiological studies on the occurrence of primary liver cancer in Thailand and different regions of middle and southern Africa are described.