Early detection and successful treatment of Wernicke encephalopathy in a patient with advanced carcinoma of the external genitalia during chemotherapy
| Autor: | Keiichi Fujiwara, Iori Tanahashi, Hiroaki Toyama, Tatsuo Akechi, Yoshitada Taji, Hideki Onishi, Mayumi Ishida, Kenji Ikebuchi |
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| Rok vydání: | 2015 |
| Předmět: |
Sleep Wake Disorders
medicine.medical_specialty Pediatrics medicine.medical_treatment media_common.quotation_subject Brain damage Feeding and Eating Disorders 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Drug Therapy Humans Medicine Wernicke Encephalopathy Thiamine 030212 general & internal medicine General Nursing media_common Chemotherapy business.industry Delirium Thiamine Deficiency Cancer Appetite General Medicine Middle Aged medicine.disease Surgery Psychiatry and Mental health Clinical Psychology 030220 oncology & carcinogenesis Female medicine.symptom business Urogenital Neoplasms |
| Zdroj: | Palliative and Supportive Care. 14:302-306 |
| ISSN: | 1478-9523 1478-9515 |
| DOI: | 10.1017/s1478951515000875 |
| Popis: | Objective:Few reports of Wernicke encephalopathy in oncological settings have been published. Some cases of Wernicke encephalopathy are related to appetite loss; however, the degree to which loss of appetite leads to thiamine deficiency is not known.Method:A 63-year-old female with advanced cancer of the external genitalia was referred for psychiatric consultation because of disorientation, insomnia, and bizarre behaviors. Her symptoms fulfilled the diagnostic criteria for delirium. Routine laboratory examinations did not reveal the cause of the delirium. Thiamine deficiency was suspected because appetite loss had continued for 19 days since she had been admitted to hospital.Results:Intravenous administration of thiamine resulted in recovery from the delirium within three days. Serum thiamine level was found to be 16 ng/ml (normal range: 24–66 ng/ml). The clinical findings, the low level of thiamine in the serum, and the effective alleviation of delirious symptoms after thiamine administration fulfilled Francis's criteria for delirium induced by thiamine deficiency.Significance of results:Clinicians must be aware of the possibility of Wernicke encephalopathy in cancer patients, especially in those with loss of appetite for longer than 18 days. The degree of appetite loss in such patients might serve as a reference. Early detection and intervention may alleviate the symptoms of delirium and prevent irreversible brain damage. |
| Databáze: | OpenAIRE |
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