Table 3.

Thiamine treatment regimens and response to treatment among infants, children, and adults with varying clinical manifestations of thiamine deficiency disorders in case–control studies and hospital‐based prospective cohorts and retrospective reviews

Study	n	Age and country of patient population	Clinical presentations	Thiamine treatment dose and duration	Response to treatment
Infants and children
Rao et al.55	166	Mean age = 7 months India	Severe respiratory irregularities, ophthalmoplegia, seizures, hypotonia, fever, and vomiting. Associated features: aphonia, choreo‐athetoid movements, arreflexia, and loss of milestones, with head lag	200–300 mg daily, followed by 75 mg daily for 3 months after discharge	Consciousness, respiratory abnormalities, and ptosis improved within 24 hours Head control, tone, involuntary movements, and milestones recovered partially over a few weeks Developmental delay and hypotonia remained at 3–6 months follow‐up in two cases with persistent computed tomography head lesions
Rao and Chandak27	55	Mean age 3.9 months India	Tachypnea, chest indrawing, tachycardia, high output heart failure, and pulmonary hypertension, but also hepatomegaly, cough, fever, aphonia, nystagmus, and altered consciousness	75 mg IM twice daily for 5 days	Reversal of right arterial and ventricular dysfunction at 2–3 weeks follow‐up in 19 cases
Coats et al.43	27	≤7 months Cambodia	Hepatomegaly, respiratory rate ≥40, heart rate ≥140, absence of fever, and at least two of the following: aphonia or dysphonia, wheezing, decreased urine output, recent vomiting, and irritability	100 mg IM for 3 days	Respiratory rate decreased by ≥10 breaths/min in 26% by 24 h and in 38% by 72 hours Heart rate decreased by ≥20 beats/min in 30% by 24 h and in 33% by 72 hours Twenty percent had decreased liver size by ≥1 cm by 72 hours
Porter et al.9	20	2–47 weeks Cambodia	Hepatomegaly, respiratory rate ≥40, heart rate ≥140, temperature <37.5 °C	100 mg IM for 3 days	Significant decreases in respiratory and heart rate and liver size by 48 hours Two cases with right ventricular enlargement improved within 48 hours
Qureshi et al.53	23	32 days–4 months India	Tachycardia, irritability in the form of excessive crying and restlessness, moaning, reduced feeding for 1 day and seizures Blood lactate levels were >15 mmol/L in all patients	100 mg IV on admission, and 50 mg IV daily until discharge from hospital	Moaning subsided within 2 h, vacant stare and tachycardia within 4 h, and normalization of breastfeeding within 12 hours Blood lactate <4 mmol/L was attained within 4 hours Hyperechoic putamen reversed at 1‐month follow‐up in eight cases
Wani et al.22	58	35 days–9 months India	Infantile encephalitic beriberi: altered consciousness, seizures, altered personality, or cognition	100 mg IV on admission to hospital	Regression of basal ganglia hyperechogenicity with almost normal appearance at 2–4 weeks follow‐up in 18 infants and at 4–8 weeks in an additional 8 infants Ten infants with persistent basal ganglia hyperechogenicity showed delayed developmental milestones
Bhat et al.58	50	1–6 months India	Infants with acute onset encephalopathy: irritability, blephroptosis, gastroesophageal reflux, seizures, right heart failure, vacant stare, and aphonia	100 mg IV daily and 10 mg/day orally after discharge	Improvement in symptoms in median time of 7 hours Eight patients were discharged with some neurological deficits in the form of aphonia, multiple cranial neuropathies, or motor deficits
Sastry et al.56	231	Mean age 3.2 months India	Fast breathing, chest retractions, irritability, poor feeding, vomiting, aphonia, tachypnea, tachycardia, and hepatomegaly	100 mg IV daily for 3 days	Pulmonary hypertension resolved in 92% of cases within 24–48 hours. Within 6 h, feeding improved and vomiting ceased Tachypnea, tachycardia, and hepatomegaly reduced within 24 hours Aphonia resolved over 3–4 days.
Thankaraj et al.54	28	Mean age 69 days India	Tachycardia, prolonged capillary refill time, severe respiratory distress, seizures, vomiting, breathlessness, and poor feeding	100 mg IV daily for a minimum of 7 days	Resolution of shock within 24 h and initiation of breastfeeding within 2 days Fourteen infants requiring invasive ventilation could be weaned within 60 h, with 12 infants being extubated within 24 hours Improvement in capillary blood gas measurements within 4–8 hours
Adults
Shah et al.66	50	23–80 years India	Nonalcoholic Wernicke's encephalopathy mainly presenting with nausea/vomiting, nystagmus, lower limb weakness, ataxia, altered mental status, and memory impairment	300–600 mg IV twice daily for 5–10 days, followed by 100–300 mg/day oral maintenance	Nine patients had residual symptoms after 9 days of treatment, mainly lower limb weakness, ataxia, memory impairment, and psychosis One patient developed Korsakoff psychosis
Koshy et al.70	24	15–40 years India	Peripartum women with peripheral neuropathy and/or cardiopathy	200 mg IV or IM per day for an average of 7 days, followed by B‐complex (33 mg thiamine) twice daily at discharge	Ninety percent of patients reported improvements in neurological deficits or in nerve conduction studies after an average of 10 days One patient with repeat echocardiogram 1 week after treatment showed improved cardiac output and disappearance of a functional mitral regurgitation
Nilles et al.38	69	Median age 28 years (range 0–62) Kiribati	Eighty‐three percent of cases were male. Main features were weakness, paresthesia, numbness, pain, or edema of the extremities	100 mg IM daily for 1–3 days, followed by 100 mg oral daily for 3–6 weeks	Ninety‐four percent of cases reported complete or near‐complete resolution of symptoms within 7 days Of cases unable to complete squat tests or heel walk tests, 55–77% could successfully complete within 3–7 days of treatment
Hilal Ahmad et al.69	29	Mean age 30.2 years India	Peripartum women with peripheral neuropathy	200–500 IV three times daily for 3–5 days, followed by oral thiamine	Within 24–72 h, 27 patients showed improvements in weakness, mental status, ophthalmoparesis, and nystagmus and resolution of edema

IM, intramuscular; IV, intravenous.