Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.

<h4>Background</h4>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 o...

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Main 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-02-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000971&type=printable
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author 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
author_facet 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
author_sort Douangdao Soukaloun
collection DOAJ
description <h4>Background</h4>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.<h4>Methodology/principal findings</h4>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%CI 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.<h4>Conclusions/significance</h4>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.
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language English
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publisher Public Library of Science (PLoS)
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spelling doaj-art-c4e825f9e5c842ca8490e4e6247b960d2025-08-20T03:46:24ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352011-02-0152e97110.1371/journal.pntd.0000971Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.Douangdao SoukalounSue J LeeKaren ChamberlainAnn M TaylorMayfong MayxayKongkham SisoukBandit SoumphonphakdyKhaysy LatsavongKongsin AkkhavongDouangkham PhommachanhVanmaly SengmeuangKhonsavanh LuangxayTheresa McDonaghNicholas J WhitePaul N Newton<h4>Background</h4>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.<h4>Methodology/principal findings</h4>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%CI 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.<h4>Conclusions/significance</h4>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.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000971&type=printable
spellingShingle 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
Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
PLoS Neglected Tropical Diseases
title Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
title_full Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
title_fullStr Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
title_full_unstemmed Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
title_short Erythrocyte transketolase activity, markers of cardiac dysfunction and the diagnosis of infantile beriberi.
title_sort erythrocyte transketolase activity markers of cardiac dysfunction and the diagnosis of infantile beriberi
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000971&type=printable
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