Wernicke encephalopathy in a lung cancer patient receiving home medical care

Abstract Objective Cancer patients often want to spend their final days at home, and it is essential that general practitioners have knowledge of and technical skills related to cancer medicine and symptom relief. Recent clinical studies have revealed that Wernicke encephalopathy (WE) is quite common in cancer patients. However, there have been no reports to date on WE in cancer patients undergoing home medical care. Methods From a series of cancer patient undergoing home medical care, we reported a patient with lung cancer who developed WE. Results An 84-year-old female with lung cancer undergoing home medical care developed an impaired mental state and an attention deficit. Her symptoms fulfilled the diagnostic criteria for delirium. WE was suspected as the patient's food intake had fallen from normal a month previously to somewhere between 50% or just a few mouthfuls. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after thiamine administration. Significance of the results When delirium occurs in cancer patients undergoing home treatment, it is necessary to suspect thiamine deficiency as a potential cause, as appropriate diagnosis and treatment can prevent irreversible brain-related sequelae.

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Abstract 2025: Racial differences in lung cancer patient experiences with medical care and their association with cancer mortality: A SEER-CAHPS study

10.1158/1538-7445.am2020-2025 ◽

2020 ◽

Author(s):

Emily Chan ◽

Elizabeth A. David ◽

Megan Eguchi ◽

Myles Cockburn ◽

Albert J. Farias

Keyword(s):

Lung Cancer ◽

Cancer Patient ◽

Medical Care ◽

Racial Differences ◽

Cancer Mortality ◽

Lung Cancer Patient ◽

Patient Experiences

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Wernicke encephalopathy in a lung cancer patient during treatment with nivolumab

Palliative & Supportive Care ◽

10.1017/s1478951518000469 ◽

2018 ◽

Vol 17 (2) ◽

pp. 245-247 ◽

Cited By ~ 2

Author(s):

Hideki Onishi ◽

Mayumi Ishida ◽

Hiroshi Kagamu ◽

Yoshitake Murayama ◽

Kunihiko Kobayashi ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patient ◽

Thiamine Deficiency ◽

Lung Cancer Patient ◽

Advanced Lung Cancer ◽

Wernicke Encephalopathy ◽

Laboratory Findings ◽

Patients With Cancer ◽

Cancer Trajectory ◽

Loss Of Appetite

AbstractObjectiveWernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. It is recognized in various stages of the cancer trajectory but has not previously been recognized during nivolumab treatment.MethodFrom a series of WE patients with cancer, we report a lung cancer patient who developed WE during treatment with nivolumab.ResultA 78-year-old woman with lung cancer was referred to our psycho-oncology clinic because of depressed mood. Psychiatric examination revealed disorientation to time, date, and place, which had not been recognized 1 month previously. Her symptoms fulfilled the diagnostic criteria for delirium. No laboratory findings or drugs explaining her delirium were identified. WE was suspected as she experienced a loss of appetite lasting 4 weeks. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after intravenous thiamine administration.Significance of resultsWe found WE in an advanced lung cancer patient receiving treatment with nivolumab. Further study revealed the association between nivolumab and thiamine deficiency. Oncologists should consider thiamine deficiency when a patient experiences a loss of appetite of more than 2 weeks regardless of the presence or absence of delirium.

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