An underestimated diagnosis in practice: wernicke encephalopathy in two cancer patients

2017 ◽  
Author(s):  
Miraç Ayşen Ünsal ◽  
Dilaver Kaya
Keyword(s):  
Cancer Patients ◽  
Wernicke Encephalopathy

Subclinical thiamine deficiency in patients with abdominal cancer

2017 ◽  
Vol 16 (4) ◽  
pp. 497-499 ◽  
Author(s):  
Hideki Onishi ◽  
Mayumi Ishida ◽  
Iori Tanahashi ◽  
Takao Takahashi ◽  
Yoshitada Taji ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Thiamine Deficiency ◽  
Storage Capacity ◽  
Clinical Symptoms ◽  
Performance Status ◽  
Clinical Signs ◽  
Medical Emergency ◽  
Wernicke Encephalopathy ◽  
Appetite Loss ◽  
Pancreatic Body Cancer

AbstractObjectiveThiamine is an essential coenzyme for oxidative metabolisms; however, it is not synthesized in the human body, and the average thiamine storage capacity is approximately 18 days. Therefore, thiamine deficiency (TD) can occur in any condition of unbalanced nutrition. If TD is left untreated, it causes the neuropsychiatric disorder Wernicke encephalopathy (WE). Although WE is a medical emergency, it is sometimes overlooked because most patients with WE do not exhibit all of the typical symptoms, including delirium, ataxia, and ophthalmoplegia. If all of the typical clinical symptoms of WE are absent, diagnosis of TD or WE becomes more difficult.MethodFrom a series of cancer patients, we reported three patients who developed TD without the typical clinical symptoms of WE.ResultA 69-year-old woman with pancreatic body cancer receiving chemotherapy with paclitaxel and gemcitabine for six months. Her performance status (PS) was 1. A detailed interview revealed that she had appetite loss for six months. Another 69-year-old woman with ovarian cancer received nedaplatin; her PS was 0. A detailed interview revealed that she had appetite loss for three months. A 67-year-old woman with colon cancer receiving ramucirumab in combination with second-line fluorouracil with folinic acid and irinotecan. Her PS was 1. A detailed interview revealed that she had appetite loss for three weeks. None exhibited typical clinical signs of WE, but they developed appetite loss for six months, three months, and three weeks, respectively. The diagnosis of TD was supported by abnormally low serum thiamine levels.Significance of the resultsThis report emphasizes the possibility of TD in cancer patients even when patients do not develop typical clinical signs of WE. The presence of appetite loss for more than two weeks may aid in diagnosing TD. Patients receiving chemotherapy may be at greater risk for developing TD.

Wernicke encephalopathy in a lung cancer patient receiving home medical care

2021 ◽  
pp. 1-3
Author(s):  
Hiroshi Ito ◽  
Mayumi Ishida ◽  
Kumi Itami ◽  
Akira Yoshioka ◽  
Izumi Sato ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patient ◽  
Medical Care ◽  
Cancer Patients ◽  
Lung Cancer Patient ◽  
Symptom Relief ◽  
Technical Skills ◽  
Wernicke Encephalopathy ◽  
Home Medical Care ◽  
Cancer Medicine

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.

Wernicke encephalopathy presented in the form of postoperative delirium in a patient with hepatocellular carcinoma and liver cirrhosis: A case report and review of the literature

2005 ◽  
Vol 3 (4) ◽  
pp. 337-340 ◽  
Author(s):  
HIDEKI ONISHI ◽  
YUKIO SUGIMASA ◽  
CHIAKI KAWANISHI ◽  
MASANARI ONOSE
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Cancer Patients ◽  
Brain Damage ◽  
Postoperative Delirium ◽  
Laboratory Data ◽  
Wernicke Encephalopathy ◽  
Irreversible Brain Damage ◽  
Thiamine Level ◽  
Lower Limit Of Normal

Objective: Although Wernicke encephalopathy has been reported in the oncological literature, it has not previously been reported in postoperative cancer patients.Methods: In this communication, we report a patient of hepatocellular carcinoma with liver cirrhosis who developed Wernicke encephalopathy in the form of postoperative delirium. Preoperatively, the patient had a very good appetite and had eaten all the food of an 1800 cal/day diet until 1 day before operation. The operation was done without any complications. The patient developed delirium 2 days after the lobectomy of the liver. The level of delirium remained unchanged until administration of thiamine starting on day 7 postoperatively, which resulted in palliation of delirium without brain damage. Laboratory data demonstrated that the serum thiamine level at day 6 postoperatively was below the lower limit of normal. As the mechanism of Wernicke encephalopathy, we thought that decreased ability to store thiamine due to liver cirrhosis led to depletion of thiamine faster than had been expected.Results and significance of the research: In cancer patients, clinicians must always remain aware of the possibility of Wernicke encephalopathy, especially in patients with liver dysfunction, which decreases the ability to store thiamine in the liver. Early detection and intervention may alleviate the symptoms of delirium and prevent irreversible brain damage.

Dental management of cancer patients: curricular implications

1974 ◽  
Vol 38 (11) ◽  
pp. 642-644
Author(s):  
W Carl ◽  
AJ Drinnan
Keyword(s):  
Cancer Patients ◽  
Dental Management

Evaluating the effect of a group pre-treatment chemotherapy psycho-education session for chemotherapy-naive gynecologic cancer patients and their caregivers

2021 ◽  
Vol 160 (1) ◽  
pp. 234-243
Author(s):  
Diana Samoil ◽  
Nazek Abdelmutti ◽  
Lisa Ould Gallagher ◽  
Nazlin Jivraj ◽  
Naa Kwarley Quartey ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Education Session ◽  
Pre Treatment

895: Proteomic Analysis of Sera from Bladder Cancer Patients with MALDI-TOF-MS

2007 ◽  
Vol 177 (4S) ◽  
pp. 297-297
Author(s):  
Kristina Schwamborn ◽  
Rene Krieg ◽  
Ruth Knüchel-Clarke ◽  
Joachim Grosse ◽  
Gerhard Jakse
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Proteomic Analysis ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Tof Ms

390: Durable Cancer Control in High Risk Prostate Cancer Patients Treated with Radical Prostatectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 130-130
Author(s):  
Markus Graefen ◽  
Jochen Walz ◽  
Andrea Gallina ◽  
Felix K.-H. Chun ◽  
Alwyn M. Reuther ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Cancer Control ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

598: Increased Risk of Newly Diagnosed Comorbidities in Prostate Cancer Patients Treated with Androgen Deprivation Therapy

2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200 ◽  
Author(s):  
Andrea Gallina ◽  
Pierre I. Karakiewicz ◽  
Jochen Walz ◽  
Claudio Jeldres ◽  
Quoc-Dien Trinh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Newly Diagnosed ◽  
Increased Risk
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