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Figure 2 (Left) Arterial and central venous blood pressure and (right) urine output of a patient who was admitted with unexplained acute renal failure in a very weak physical state and whose speech (although very weak) was copious and confused. The patient was discovered to be a regular beer drinker consuming 6-12 pints daily, and his usual food intake amounted to no more than a sausage roll or pie. He had become progressively weaker over the past 8 weeks and had eaten nothing at all in the past 2 weeks. After excluding other diagnoses, it was suspected that the patient had fulminant beriberi and he was treated with thiamin after 36 h. The figures display the rapidly increasing arterial pressure, fall in venous pressure, and a rapid resumption in renal function following thiamin treatment. The patient lost ~20l of urine during the first 7days in the hospital. (Modified from Anderson SH, Charles TJ and Nicol AD (1985) Thiamine deficiency at a district general hospital: Report of five cases. Quarterly Journal of Medicine 55: 15-32.)

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