Vitamin B1 deficiency
ICD-10 E51.1 · ICD-11 5B5A.0

Treatment of Vitamin B1 Deficiency in an Infant with Severe Heart Failure, Convulsions, or Coma

Clinical Scenario

This protocol addresses severe thiamine (vitamin B1) deficiency in infants who present with severe heart failure, convulsions, or coma — an acute, life-threatening presentation that requires prompt clinical action.

Infant Severe thiamine deficiency Severe heart failure Convulsions Coma

Treatment Approach

Management begins with urgent parenteral thiamine, administered via a specific intravenous route, followed by a structured transition through subsequent phases of supplementation. The full sequencing, route details, and duration are defined in the complete protocol.

Clinical goal: when treatment is initiated appropriately, the response in affected infants can be dramatic — symptomatic relief within hours.
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References

In severe deficiency states the following dosages are recommended:

if severe heart failure, convulsions or coma occur, 25–50 mg of thiamine should be given very slowly intravenously, followed by a daily intramuscular dose of 10 mg for about a week.

This should then be followed by 3–5 mg of thiamine per day orally for at least 6 weeks.

In infants with thiamine deficiency and in adults with cardiac insufficiency the response to treatment is dramatic, with symptomatic relief within hours, whereas deficiency states with peripheral neuritis show a less spectacular improvement.

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