Keywords
thiamine
diagnosis
beriberi
How to Cite
Abstract
Erythrocyte transketolase activation test (TK-E) by exogenous thiamine pyrophosphate (TPP) is an indirect method to measure thiamine (vitamin B1). The decrease in the erythrocyte transketolase activity and the increase of in vitro stimulation with TPP greater than 17 % indicate thiamine deficiency. It is a reasonable method as the major portion of this vitamin are concentrated in erithrocytes. Due to the beriberi outbreaks that have occurred in Brazil since 2006, the Adolfo Lutz Institute (IAL), as a Central Public Health Laboratory, proposed the implementation of this method to give support to the investigation on the new outbreaks or isolated cases. The evaluated parameters were precision, linearity, hemolysate and sample stability, and the limits of detection and quantification were estimated. The TK-E activity without activation by TPP was 0.732 UI/gHb, and with activation was 0.827 UI/gHb. All of the results obtained from the evaluated parameters showed to be within the eligibility criteria, ensuring the reliability of the proposed methods. Thus, this method showed to be adequate as biochemical assay for the Public Health Network. However, there is a need to define the reference values to establish the clinical limits of thiamine deficiency.
References
1. Bayoumi RA, Rosalki SB. Evaluation of methods of coenzime activation of erythrocyte enzymes for detection of deficiency of vitamins B1, B2 and B6. Clin Chem. 1976; 22(3): 327-35.
2. Andrade JA, Gayer CR, Nogueira NP, Paes MC, Bastos VL, Neto Jda C, et al. The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis. J Inflamm (Lond). 2014;11:11. [DOI: 10.1186/1476-9255-11-11].
3. Stroh C, Meyer F, Manger T. Beriberi, a severe complication after metabolic surgery - review of the literature. Obes Facts. 2014;7(4):246-52. [DOI: 10.1159/000366012].
4. Ministério da Saúde. Secretaria de Atenção à Saúde. Secretaria Especial de Saúde Indígena. Secretaria de Vigilância em Saúde. Guia de Consulta para Vigilância Epidemiológica, Assistência e Atenção Nutricional dos casos de Beriberi. 1ª Edição. 2012. Brasília. 66p.
5. Talwar D, Davidson H, Cooney J, O`Reilly D. Vitamin B1 status assessed by direct measurement of thiamin pyrophosphate in erythrocytes or whole blood by HPLC: comparison with erythrocyte transketolase activation assay. Clin Chem. 2000; 46:704-10.
6. Michalak S, Michatowska-Wender G, Adamcewicz G, Wender MB. Erythrocyte transketolase activity in patients with diabetic and alcoholic neuropathies. Folia Neuropathol. 2013; 51(3):222-6. [DOI: https://doi.org/10.5114/fn.2013.37706].
7. Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamine and its derivatives. Evid Based Complement Alternat Med. 2006;3(1):49-59. [DOI: 10.1093/ecam/nek009].
8. Cerroni MP, Barrado JC, Nobrega AA, Lins AB, Silva IP, Mangueira RR, et al. Outbreak of Beriberi in an indian populationof the upper Amazon region, Roraima state, Brazil, 2008. Am J Trop Med Hyg. 2010;83(5):1093-7. [DOI: 10.4269/ajtmh.2010.10-0345].
9. Alves LF, Gonçalves RM, Cordeiro GV, Lauria MW, Ramos AV. Beriberi pós bypass gástrico: uma complicação não tão rara. Relato de dois casos. Revisão da literatura. Arq Bras Endocrinol Metabol. 2006;50(3):564-8. [DOI: http://dx.doi.org/10.1590/S0004-27302006000300021].
10. Manatakis DK, Georgopoulos N. A fatal case of Wernicke’s Encephalopathy after sleeve gastrectomy for morbid obesity. Case Rep Surg. 2014;2014:281210. [DOI: http://dx.doi.org/10.1155/2014/281210].
11. Coelho LS, Hueb JC, Minicucci MF, Azevedo PS, Paiva SA, Zornoff LA. Thiamin deficiency as a cause of reversible cor pulmonale. Arq Bras Cardiol. 2007;91(1):e7-9. [DOI: 10.1590/S0066-782X2008001300013].
12. Gratton SM, Lam BL. Visual loss and optic nerve head swelling in thiamine deficiency without prolonged dietary deficiency. Clin Ophthalmol. 2014;8:1021-4. [DOI: 10.2147/OPTH.S64228].
13. Crook MA, Sriram K. Thiamine deficiency: the importance of recognition and prompt management.Nutrition.2014;30(7-8):953-4. [DOI: http://dx.doi.org/10.1016/j.nut.2014.03.003].
14. Sechi G, Serra A. Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007;6(5):442-55. [DOI: http://dx.doi.org/10.1016/S1474-4422(07)70104-7].
15. Raziel AR. Thiamine deficiency after bariatric surgery may lead to Wernicke encephalopathy. Isr Med Assoc J. 2012;14(11):692-4.
16. Da Cunha S, Albanesi Filho FM, da Cunha Bastos VL, Antelo DS, Souza MM. Thiamin, selenium, and copper levels in patients with idiopathic dilated cardiomyopathy taking diuretics. Arq Bras Cardiol. 2002;79(5):454-65. [DOI: http://dx.doi.org/10.1590/S0066-782X2002001400003]
17. Instituto Nacional de Metrologia, Qualidade e Tecnologia – INMETRO. DOQ-CGCRE-008- Orientação sobre validação de métodos analíticos. Rev 04. Rio de Janeiro (RJ): Coordenação Geral de Acreditação; 2011.
18. Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Resolução RDC n°27, de 17 de maio de 2012. Dispõe sobre os requisitos mínimos para a validação de métodos bioanalíticos empregados em estudos com fins de registro e pós-registro de medicamentos. Diário Oficial [da] República Federativa do Brasil. Brasília, DF, 22 maio 2012.
19. Oliveira CA, Mendes ME. Gestão de Fase Analítica do Laboratório- como assegurar a qualidade na prática. 1a ed. Rio de Janeiro (RJ); 2010.
20. Bailey AL, Finglas PM, Wright AJ, Southon S. Thiamin intake, erythrocyte transketolase (EC 2.2.1.1) activity and total erythrocyte thiamin in adolescents. Br J Nutr. 1994; 72(1):111-25. [DOI: https://doi.org/10.1079/BJN19940014].
21. Soukaloun D, Lee SJ, Chamberlain K, Taylor AM, Mayxay M, Sisouk K et al. Erythrocyte transketolase activity, markers cardiac dysfunction an the diagnosis of infantile beriberi. PLoS Negl Trop Dis. 2011;5(2):e971. [DOI: http://dx.doi.org/10.1371/journal.pntd.0000971].
22. Smeets EHJ, Muller H, de Wael J. A NADH-dependent transketolase assay in erythrocyte hemolysates. Clin Chim Acta. 1971;33:379-86. [DOI:10.1016/0009-8981(71)90496-7].
23. Waring PP, Fisher D, McDonnell J, McGown EL, Sauberlich H. A continuous-flow (AutoAnalizer II) procedure for measuring erythrocyte transketolase activity. Clin Chem.1982; 28(11):2206-13.
24. Beutler E. Red cell metabolism- A manual of biochemical methods. 3a ed. Orlando (FL): Grune & Stration; 1984.
25. Rosa CA, Keller KM, Oliveira AA, Almeida TX, Keller LA, Marassi AC, et al. Production of citreoviridin by Penicillium citreonigrum strains associated with rice consumption and beriberi cases in the Maranhão State, Brazil. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2010;27(2):241-8. [DOI: http://dx.doi.org/10.1080/19440040903289712].
26. Ringe H, Schuelke M, Weber S, Dorner BG, Kirchner S, Dorner MB. Infant Botulism: is there an association with thiamine deficiency? Pediatrics. 2014;134(5):e1436-40. [DOI: 10.1542/peds.2013-3378].
27. Mitsumida N, Umeda H, Iwase M. Shoshi Beriberi induced by long-term administration of diuretics: a case report. Case Rep Cardiol. 2014; 2014:878915. [DOI: http://dx.doi.org/10.1155/2014/878915].
28. Winston AP, Jamieson CP, Madira W, Gatward NM, Palmer RL. Prevalence of thiamin deficiency in anorexia nervosa. Int J Eat Disord. 2000;28:451-4. [DOI: 10.1002/1098-108X(200012)28:4<451::AID-EAT14>3.0.CO;2-I]
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