Subclinical thiamine deficiency identified by pretreatment evaluation in an esophageal cancer patient
Open Access
- 7 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Nutrition
- Vol. 75 (3), 564-566
- https://doi.org/10.1038/s41430-020-00735-y
Abstract
Despite the fact that both thiamine deficiency (TD) and Wernicke encephalopathy (WE) have been observed to some degree in cancer patients, such cases of TD and/or WE reported to date have all been diagnosed after the initiation of treatment. We here report a case of TD that presented without the commonly accepted triad of WE symptoms based on a total nutritional evaluation prior to the onset of treatment for cancer. The patient was a 71-year-old man with esophageal cancer who was referred to the oncology outpatient clinic for evaluation to determine the treatment plan. Although he did not present with delirium, cerebellar signs, or ocular symptoms, TD was suspected based on a reduction in appetite lasting 2 months as thiamine stores in the body are depleted in as few as 18 days. Blood findings showed a marked decline in serum thiamine level supported, which the diagnosis of TD. This case revealed the existence of a cancer patient with subclinical TD prior to the onset of treatment for cancer. Due to the fact that TD can occur without the characteristic symptoms as in this case, we believe it is important that total nutritional evaluation of cancer patients always be considered.Keywords
This publication has 20 references indexed in Scilit:
- Palliative treatment of thiamine-related encephalopathy (Wernicke's encephalopathy) in cancer: A case series and review of the literaturePalliative & Supportive Care, 2014
- EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathyEuropean Journal of Neurology, 2010
- Wernicke Encephalopathy Complicating Lymphoma Therapy: Case Report and Literature ReviewSouthern Medical Journal, 2007
- Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and managementThe Lancet Neurology, 2007
- Successful treatment of Wernicke encephalopathy in terminally ill cancer patients: Report of 3 cases and review of the literatureSupportive Care in Cancer, 2004
- Thiamine for Wernicke-Korsakoff Syndrome in people at risk from alcohol abusePublished by Wiley ,2004
- Thiamin Treatment and Working Memory Function of Alcohol‐Dependent People: Preliminary FindingsAlcohol: Clinical and Experimental Research, 2001
- Thiamine deficiency in patients admitted to a palliative care unitPalliative Medicine, 1994
- Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy.Journal of Neurology, Neurosurgery & Psychiatry, 1986
- Nutrition Following Gastric Operations for Morbid ObesityAnnals of Surgery, 1983