Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_435»
«MEDICAL WRITING: CASE ABSTRACT_435»
·What is a medical case report?
·What parts does it include?
·What is an abstract?
Read the abstract of the medical case
polyneuropathy due to dry beriberi in a man: a case report
We describe a case of rapidly
progressive and severely debilitating polyneuropathy in a patient with
confirmed hypovitaminosis B1, consistent with dry beriberi. Crucially, this is
a treatable condition, although sometimes with incomplete recovery, but it is
probably under-recognized yet increasingly common given increasing levels of
alcohol abuse in the western world.
A 49-year-old Caucasian British
man presented with progressive weakness of both lower limbs of approximately
seven months' duration. He noted difficulty climbing stairs. He also complained
of lethargy, and loss of muscle bulk, including his thighs. He had a history of
type 2 diabetes mellitus and admitted prior alcohol abuse but denied excessive
alcohol intake in the five years prior to presentation. Initial clinical and
neurophysiological examinations were consistent with a mild peripheral
neuropathy and probable proximal myopathy. However, over the subsequent four
months he evolved a marked tetraparesis, with profound sensory disturbance of
all limbs. Repeat neurophysiology revealed a widespread polyneuropathy with
extensive acute and sub-acute denervation changes in all four limbs, and
reduced or absent sensory nerve action potentials. Hypovitaminosis B1 was
confirmed (45 nmol/L, reference range 66-200 nmol/L). His rapid clinical
deterioration was in keeping with dry beriberi. He was treated with thiamine.
Subsequent follow-up revealed slow but significant improvement, such that by
15-16 months from the initial onset of symptoms, and approximately six months
after the onset of his marked tetraparesis, he was able to stand independently
and was gradually gaining confidence in walking pending a period of in-patient
A potentially wide differential
diagnosis exists for this type of presentation. Confirming hypovitaminosis B1
by requesting the assay prior to vitamin replacement ensures accurate diagnosis
and appropriate ongoing treatment. An increasingly high index of suspicion is
likely to be required in the context of increasing levels of alcohol abuse in
the western world and the possible increasing prevalence of dry beriberi.
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1.Is this the first report of this kind in the literature?
2.What are brief details of what the patient(s) presented with?
3.What the reader should learn from the case report?
4.What the clinical impact will be?
5.Is it an original case report of interest to a particular clinical
specialty of medicine?
6.Will it have a broader clinical impact across medicine?
7.Are any teaching points identified?
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