Shoshin beriberi: an underdiagnosed condition?

Shoshin beriberi, a fulminant form of heart failure due to thiamine deficiency has a different presentation to the classical form of beriberi heart failure. It is characterized by a cold periphery, low blood pressure, renal shutdown and a severe metabolic acidosis. The true incidence is unknown. Two patients were seen within a few months in a general hospital and in both dietary deficiency of thiamine was a major factor.