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Troponin I (TnI) elevation is the direct result of cardiomyofibril damage and subsequent release into the circulation. There are many causes for TnI elevation1 but no previous reports have addressed the metabolic problem of beriberi or thiamine deficiency and TnI elevation. This report highlights two cases of TnI elevation in the presence of beriberi.
Investigations in both cases were undertaken in the same laboratory. TnI was analysed using the Beckmann Coulter Access II platform with a coefficient variation of 5.6%. The detection limit is 0.01 μg/l and the upper reference limit is 0.03 μg/l at the 97.5th centile.2
Patient 1 was a 64 year old widow with chronic alcoholic cirrhosis and ongoing alcohol consumption at around 40 to 60 g/day. She presented with a sudden collapse without any preceding symptoms. Her blood pressure was posturally low at 140/80 lying and 110/70 sitting, with moderate dehydration and evidence of mild biventricular failure. Her …