Severe thiamine deficiency resulted in Wernicke's encephalopathy in a chronic dialysis patient

Clinical and Experimental Nephrology
Kae UedaYasuo Katayama

Abstract

A 64-year-old male patient with diabetic nephropathy had been treated with maintenance hemodialysis therapy for 4 years, and had developed disturbed consciousness. The disturbance was firstly noticed by a primary care doctor who recognized slow responses in conversation. Prior to developing this symptom, the patient had noticed a loss of appetite for about 2 weeks. During a period of observation at an outpatient clinic, the symptoms became worse. He was admitted to a primary care hospital for 10 days, but his consciousness level deteriorated and he became unconscious (JCS 200). About 1 month after the onset of symptoms, the patient was transferred to our hospital. A brain computed tomography (CT) scan and magnetic resonance imaging (MRI) showed typical abnormal lesions in the aquaduct of the midbrain and thalamus, and a diagnosis of Wernicke's encephalopathy was made. In addition, the patient's serum thiamine level was extremely low (7 ng/ml). He received immediate treatment with intravenous thiamine administration (150 mg/day), and this significantly improved his symptoms (JCS 2). Dialysis patients may develop water-soluble vitamin deficiency as a result of the combination of reduced oral intake and increased loss of vitamins ...Continue Reading

References

Feb 7, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S C HungT P Huang
Oct 31, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S C HungT P Huang

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Citations

May 12, 2012·Neuropsychology Review·Mary E Lough
Nov 10, 2011·Toxins·Nicole SchuppHelga Stopper
Jul 3, 2010·Rinshō shinkeigaku = Clinical neurology·Setsu Nakatani-EnomotoYoshikazu Ugawa
Feb 8, 2014·Renal Failure·George KosmadakisDidier Aguilera
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Jul 29, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Lyndsay A HarshmanJennifer G Jetton

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