Virginia Via Research Day Book 2026

Medical Student Research Case Reports

05 THIAMINE DEFICIENCY PRESENTING AS ATAXIA AND CONFUSION IN A 3-YEAR-OLD CHILD WITH RESTRICTIVE EATING PATTERNS: A CASE REPORT

Ashley Nguyen, OMS-III; Kilian H. Brech II, MD Corresponding author: anguyen07@vcom.edu

VCOM-Virginia, Blacksburg, Virginia Physicians to Children, Inc.

empiric intravenous thiamine with rapid neurological improvement, resolution of ataxia, and normalization of laboratory values. He was discharged on oral thiamine supplementation with full recovery. Comments: This presentation aligns with emerging reports of pediatric thiamine deficiency associated with selective or restrictive eating behaviors. While classically linked to alcoholism or severe malnutrition, recent studies describe similar cases in otherwise healthy children whose diets lack sufficient thiamine rich foods. The vague symptoms, such as ataxia and encephalopathy, may mimic infectious, metabolic, or structural etiologies, contributing to delayed recognition.

Context: Thiamine Deficiency is considered rare in high-income countries; however, recent literature highlights its occurrence in pediatric patients with restrictive eating patterns, even in the absence of overt malnutrition. This case illustrates a delayed diagnosis in a young child presenting with acute neurological symptoms. Report of Case: A 3-year-old male presented with acute ataxia, confusion, and decreased oral intake. His mother described a longstanding pattern of restrictive eating and picky food preferences. On evaluation, he exhibited normochromic normocytic anemia, mild lactic acidosis, and normal abdominal and intracranial imaging. Thiamine levels were later found to be undetectable. The patient received

Diagnosis: Severe thiamine deficiency was confirmed with undetectable serum thiamine levels and rapid response to supplementation. IRB Statement: Informed consent was obtained from the patient's parent for this case report.

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42 Edward Via College of Osteopathic Medicine (VCOM)