Subclinical thiamine deficiency identified by preoperative evaluation in an ovarian cancer patient: Diagnosis and the need for preoperative thiamine measurement

Palliative & Supportive Care
Hideki OnishiTatsuo Akechi

Abstract

Although thiamine deficiency (TD) and Wernicke encephalopathy (WE) are not rare in cancer patients, the cases reported to date developed TD and/or WE after treatment had started. From a series of cancer patients, we report a patient diagnosed with TD without the typical clinical symptoms of WE at the preoperative psychiatric examination. A 43-year-old woman with ovarian cancer was referred by her oncologist to the psycho-oncology outpatient clinic for preoperative psychiatric evaluation. Her tumor had been growing rapidly before the referral. Although she did not develop delirium, cerebellar signs, or eye symptoms, we suspected she might have developed TD because of her 2-month loss of appetite as the storage capacity of thiamine in the body is approximately 18 days. The diagnosis of TD was supported by abnormally low serum thiamine levels. Cancer therapists need to be aware that thiamine deficiency may occur even before the start of cancer treatment. In cases with a loss of appetite of more than 2 weeks' duration, in particular, thiamine deficiency should be considered if the tumor is rapidly increasing, regardless of the presence or absence of delirium.

References

Apr 1, 1992·Cancer·H C van Zaanen, J van der Lelie
Sep 1, 1983·Annals of Surgery·L D MacLeanH M Shizgal
May 14, 2004·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Hideki OnishiKazumasa Noda
Apr 17, 2007·Lancet Neurology·Gianpietro Sechi, Alessandro Serra
Jun 15, 2016·The Lancet Oncology·GianPietro SechiChiara Fois
Jun 15, 2016·The Lancet Oncology·Elie Isenberg-GrzedaStephen E Nicolson
Jan 24, 2017·Palliative & Supportive Care·Allison J Applebaum
May 4, 2017·Palliative & Supportive Care·Hideki OnishiTatsuo Akechi

❮ Previous
Next ❯

Citations

Sep 29, 2020·Palliative & Supportive Care·Hideki OnishiMayumi Ishida
Sep 9, 2020·European Journal of Clinical Nutrition·Akira YoshiokaMayumi Ishida
Jan 31, 2019·Palliative & Supportive Care·Hideki OnishiTatsuo Akechi
Oct 13, 2020·Palliative & Supportive Care·Rose ZhangDeepti Chopra
Feb 5, 2021·Journal of Clinical Biochemistry and Nutrition·Hideki Onishi, Mayumi Ishida
Jul 31, 2021·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Yohei IimuraSeiichiro Kuroda

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. Here is the latest research on AN.