N. V. Shashikala, K. M. Arun, R. C. Ashwini, Muganagowda Patil
Bapuji Child Health Institute and Research Centre.
India
Tropical Doctor
Trop Doct 2026;
DOI: 10.1177/00494755261451113
Abstract
Thiamine deficiency is a reversible cause of severe pulmonary arterial hypertension (PAH) in early infancy, particularly among exclusively breastfed infants of mothers consuming polished rice-based diets. This retrospective case series (July 2023-July 2025) included infants aged-12 months with echocardiographically confirmed severe PAH and no structural heart disease. Eight exclusively breastfed infants (median age 2.5 months) presented with respiratory distress. All mothers consumed polished rice-based diets. Echocardiography revealed severe PAH with right-sided cardiac dilation. Thiamine therapy resulted in rapid clinical improvement within 48 h and complete resolution within two weeks, with no deaths. Thiamine deficiency should be suspected in infants with acute severe PAH, as prompt treatment leads to excellent outcomes.
Category
Class V. Pulmonary Hypertension Associated with Hematological, Systemic, Metabolic, Nutritional and Other Disorders
Environmental Factors Associated with Pulmonary Vascular Disease
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No