ICD-10: E51.12

Wet beriberi is a clinical condition associated with thiamine (vitamin B1) deficiency, characterized primarily by cardiovascular and neurological symptoms. It is classified under the ICD-10-CM code E51.12, which specifically denotes this form of beriberi.

Clinical Description of Wet Beriberi

Pathophysiology

Wet beriberi results from a deficiency of thiamine, which is crucial for carbohydrate metabolism and the proper functioning of the nervous system. The lack of thiamine leads to impaired energy production, particularly affecting tissues with high metabolic demands, such as the heart and nervous system. This deficiency can arise from inadequate dietary intake, malabsorption syndromes, or increased requirements due to conditions like chronic alcoholism or hyperthyroidism[1][2].

Symptoms

The symptoms of wet beriberi are primarily cardiovascular and may include:

• Edema: Swelling due to fluid retention, particularly in the legs and feet.
• Cardiovascular Issues: Symptoms may include tachycardia (rapid heartbeat), palpitations, and heart failure. The heart may become enlarged (dilated cardiomyopathy) due to the increased workload and fluid overload.
• Hypotension: Low blood pressure can occur, particularly in severe cases.

Neurological symptoms may also be present, although they are more pronounced in dry beriberi. These can include:

• Peripheral Neuropathy: Tingling, numbness, or pain in the extremities.
• Wernicke's Encephalopathy: In severe cases, neurological complications can arise, leading to confusion, ataxia, and ophthalmoplegia (eye movement disorders) due to thiamine deficiency.

Diagnosis

Diagnosis of wet beriberi is primarily clinical, based on the presentation of symptoms and a history of dietary intake or risk factors for thiamine deficiency. Laboratory tests may include measuring thiamine levels in the blood, but these are not always definitive. The response to thiamine supplementation can also aid in confirming the diagnosis[3][4].

Treatment

The primary treatment for wet beriberi involves thiamine supplementation, which can be administered orally or intravenously, depending on the severity of the deficiency. In cases of heart failure, additional supportive measures may be necessary, including diuretics to manage fluid overload and other medications to support cardiac function. Dietary modifications to ensure adequate thiamine intake are also essential for long-term management[5][6].

Conclusion

Wet beriberi is a serious condition resulting from thiamine deficiency, with significant cardiovascular and neurological implications. Early recognition and treatment are crucial to prevent complications and improve patient outcomes. Awareness of the risk factors and symptoms associated with this condition can aid healthcare providers in timely diagnosis and intervention.

For further information on ICD-10 codes related to thiamine deficiency, including other forms of beriberi, refer to the ICD-10-CM guidelines and resources[7][8].

Wet beriberi, classified under ICD-10 code E51.12, is a severe manifestation of thiamine (vitamin B1) deficiency. This condition primarily affects the cardiovascular and nervous systems, leading to a range of clinical presentations, signs, symptoms, and patient characteristics.

Clinical Presentation

Wet beriberi is characterized by significant cardiovascular symptoms, which can include:

• Edema: Swelling in the legs and feet due to fluid retention is a hallmark of wet beriberi. This occurs as a result of heart failure and increased capillary permeability[1].
• Heart Failure: Patients may present with symptoms of heart failure, including shortness of breath, fatigue, and palpitations. The heart may exhibit signs of dilated cardiomyopathy due to the lack of thiamine, which is essential for energy metabolism in cardiac tissues[1][2].
• Tachycardia: An increased heart rate is common, often as a compensatory mechanism for reduced cardiac output[1].

Signs and Symptoms

The signs and symptoms of wet beriberi can be grouped into cardiovascular and neurological categories:

Cardiovascular Symptoms

• Peripheral Edema: Swelling in the extremities, particularly in the lower limbs, is often observed[1].
• Ascites: Accumulation of fluid in the abdominal cavity may occur, leading to abdominal distension[1].
• Hypertension: Elevated blood pressure can be present, particularly in the early stages of the disease[1].
• Jugular Venous Distension: This may be noted upon examination, indicating increased central venous pressure[1].

Neurological Symptoms

• Wernicke's Encephalopathy: Although primarily associated with thiamine deficiency, some patients may exhibit neurological symptoms such as confusion, ataxia, and ophthalmoplegia, which can occur alongside wet beriberi[2].
• Peripheral Neuropathy: Patients may experience numbness, tingling, or weakness in the limbs due to nerve damage from prolonged thiamine deficiency[2].

Patient Characteristics

Wet beriberi is often seen in specific populations and under certain conditions:

• Nutritional Deficiencies: Individuals with poor dietary intake of thiamine, such as those with chronic alcoholism, malnutrition, or those on high-carbohydrate diets with low thiamine content, are at increased risk[1][2].
• Age and Gender: While wet beriberi can affect individuals of any age, it is more commonly observed in adults, particularly older adults and those with underlying health conditions. There is no significant gender predisposition, but certain populations may be more affected due to dietary habits[2].
• Underlying Health Conditions: Conditions that increase metabolic demand or impair absorption, such as hyperthyroidism, diabetes, or gastrointestinal disorders, can predispose individuals to thiamine deficiency and, consequently, wet beriberi[1][2].

Conclusion

Wet beriberi is a serious condition resulting from thiamine deficiency, primarily affecting the cardiovascular system. Its clinical presentation includes significant edema, heart failure symptoms, and potential neurological involvement. Understanding the signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and treatment, which typically involves thiamine supplementation and addressing underlying nutritional deficiencies. Early intervention can significantly improve patient outcomes and prevent complications associated with this deficiency.

Wet beriberi, classified under ICD-10-CM code E51.12, is a condition resulting from thiamine (vitamin B1) deficiency, primarily affecting the cardiovascular system. Understanding its alternative names and related terms can enhance clarity in medical documentation and communication. Below are some of the key alternative names and related terms associated with wet beriberi.

Alternative Names for Wet Beriberi

1. Cardiovascular Beriberi: This term emphasizes the condition's impact on the heart and circulatory system, highlighting symptoms such as edema and heart failure.

2. Thiamine Deficiency Cardiomyopathy: This name reflects the underlying cause of the condition—thiamine deficiency—and its effect on heart muscle function.

3. Wet Beri-Beri: A variation in spelling that is sometimes used interchangeably with "wet beriberi."

4. Beriberi with Edema: This term specifically points to the characteristic swelling (edema) associated with wet beriberi.

Related Terms

1. Dry Beriberi (E51.11): This is the counterpart to wet beriberi, characterized primarily by neurological symptoms rather than cardiovascular issues. It is important to differentiate between the two forms when diagnosing and treating thiamine deficiency.

2. Thiamine Deficiency: A broader term that encompasses all conditions resulting from insufficient thiamine intake, including both wet and dry beriberi.

3. Wernicke-Korsakoff Syndrome: While not synonymous with wet beriberi, this syndrome is related to severe thiamine deficiency and can occur in chronic alcoholics, leading to neurological symptoms.

4. Vitamin B1 Deficiency: This term refers to the lack of thiamine in the diet, which is the root cause of both types of beriberi.

5. Edematous Beriberi: Another term that highlights the presence of edema in wet beriberi, often used in clinical settings.

Conclusion

Understanding the alternative names and related terms for wet beriberi is crucial for healthcare professionals in accurately diagnosing and treating this condition. Proper terminology not only aids in effective communication but also ensures that patients receive appropriate care based on their specific symptoms and underlying causes. If you have further questions or need more detailed information on this topic, feel free to ask!

Wet beriberi, classified under ICD-10 code E51.2, is a condition resulting from thiamine (vitamin B1) deficiency, primarily affecting the cardiovascular and nervous systems. The diagnosis of wet beriberi involves several criteria, which can be categorized into clinical symptoms, laboratory findings, and patient history.

Clinical Symptoms

1. Cardiovascular Symptoms:
   - Edema: Swelling in the legs and feet due to fluid retention is a hallmark of wet beriberi.
   - Tachycardia: An increased heart rate is often observed.
   - Heart Failure: Symptoms may progress to heart failure, characterized by shortness of breath and fatigue.

2. Neurological Symptoms:
   - Peripheral Neuropathy: Patients may experience numbness, tingling, or pain in the extremities.
   - Wernicke's Encephalopathy: In severe cases, neurological symptoms can include confusion, ataxia, and ophthalmoplegia.

3. General Symptoms:
   - Fatigue: Generalized weakness and fatigue are common complaints.
   - Weight Loss: Unintentional weight loss may occur due to poor nutritional intake.

Laboratory Findings

1. Thiamine Levels:
   - Low serum thiamine levels can support the diagnosis, although this test may not always be performed.

2. Electrocardiogram (ECG):
   - Changes in the ECG, such as tachycardia or other arrhythmias, may be indicative of cardiovascular involvement.

3. Fluid Retention Tests:
   - Assessment of fluid retention through physical examination and possibly imaging studies can help confirm edema.

Patient History

1. Dietary History:
   - A history of inadequate dietary intake of thiamine-rich foods (such as whole grains, legumes, and nuts) is crucial. Populations at risk include those with chronic alcoholism, malnutrition, or certain medical conditions that impair absorption.

2. Medical History:
   - Conditions that may lead to increased thiamine requirements or decreased absorption, such as gastrointestinal disorders or chronic illnesses, should be considered.

3. Social History:
   - Factors such as alcohol use, socioeconomic status, and access to nutritious food can provide context for the diagnosis.

Conclusion

The diagnosis of wet beriberi (ICD-10 code E51.2) is based on a combination of clinical symptoms, laboratory findings, and patient history. Recognizing the signs and symptoms early is crucial for effective treatment, which typically involves thiamine supplementation and dietary modifications to prevent further complications. If you suspect wet beriberi, it is essential to consult a healthcare professional for a comprehensive evaluation and appropriate management.

Wet beriberi, classified under ICD-10 code E51.12, is a severe form of thiamine (vitamin B1) deficiency characterized by cardiovascular symptoms, including edema, heart failure, and peripheral neuropathy. Understanding the standard treatment approaches for this condition is crucial for effective management and recovery.

Overview of Wet Beriberi

Wet beriberi primarily affects the cardiovascular system and is often associated with high carbohydrate intake, which can exacerbate thiamine deficiency. Symptoms may include:

• Edema: Swelling due to fluid retention.
• Cardiovascular issues: Such as tachycardia, heart failure, and hypotension.
• Neurological symptoms: Including peripheral neuropathy and muscle weakness.

Standard Treatment Approaches

1. Thiamine Supplementation

The cornerstone of treatment for wet beriberi is thiamine supplementation. The recommended approach includes:

• Oral Thiamine: For mild cases, oral thiamine (typically 100 mg to 300 mg daily) may be sufficient.
• Intravenous Thiamine: In more severe cases, especially when neurological symptoms are present, intravenous thiamine is preferred. Doses can range from 200 mg to 500 mg administered three times daily for several days, followed by oral supplementation as the patient stabilizes[1].

2. Nutritional Support

Addressing dietary deficiencies is essential:

• Balanced Diet: Patients should be encouraged to consume a diet rich in thiamine, including whole grains, legumes, nuts, and fortified cereals.
• Avoiding High-Carbohydrate Diets: Since high carbohydrate intake can worsen thiamine deficiency, dietary adjustments may be necessary to ensure a balanced intake of nutrients[2].

3. Management of Complications

Monitoring and managing complications associated with wet beriberi is critical:

• Cardiovascular Monitoring: Regular assessment of heart function and fluid status is essential, especially in patients presenting with heart failure symptoms.
• Diuretics: In cases of significant edema, diuretics may be used cautiously to manage fluid overload, but they should be administered with care to avoid electrolyte imbalances[3].

4. Patient Education

Educating patients about the importance of thiamine and dietary management is vital for preventing recurrence:

• Awareness of Symptoms: Patients should be informed about the symptoms of thiamine deficiency and the importance of adhering to treatment.
• Dietary Guidance: Providing resources on thiamine-rich foods and the importance of a balanced diet can help in long-term management[4].

Conclusion

The treatment of wet beriberi focuses on thiamine supplementation, nutritional support, and the management of cardiovascular complications. Early recognition and intervention are crucial to prevent severe outcomes. Continuous education and dietary management play a significant role in recovery and prevention of recurrence. If you suspect thiamine deficiency or wet beriberi, it is essential to seek medical attention promptly to initiate appropriate treatment.

References

1. Clinical Policy: Hyperemesis Gravidarum Treatment.
2. Standard Treatment Guidelines and Essential Medicines List.
3. Clinical Features and Outcomes of Shoshin Beriberi.
4. Clinical Policy: Hyperemesis Gravidarum Treatment.