Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar
Background. Wernicke’s encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular sympt...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/624807 |
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| author | Nuria Huertas-González Virgilio Hernando-Requejo Zaida Luciano-García Juan Luis Cervera-Rodilla |
| author_facet | Nuria Huertas-González Virgilio Hernando-Requejo Zaida Luciano-García Juan Luis Cervera-Rodilla |
| author_sort | Nuria Huertas-González |
| collection | DOAJ |
| description | Background. Wernicke’s encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular symptoms, called “wet beriberi.” Association with folate deficit worsens the clinical picture. Subject. A 70-year-old man with gastric phytobezoar presented with gait instability, dyspnoea, chest pain associated with right heart failure and pericarditis, and folate deficiency. Furosemide was administered and cardiac symptoms improved but he soon developed vertiginous syndrome, nystagmus, diplopia, dysmetria, and sensitive and motor deficit in all four limbs with areflexia. Results. A cerebral magnetic resonance imaging (MRI) showed typical findings of WE. He was immediately treated with thiamine. Neurological symptoms improved in a few days and abnormal signals disappeared in a follow-up MRI two weeks later. Conclusion. Patients with malabsorption due to gastrointestinal disorders have an increased risk of thiamine deficiency, and folate deficiency can make this vitamin malabsorption worse. An established deficiency mainly shows neurological symptoms, WE, or rarely cardiovascular symptoms, wet beriberi. Early vitamin treatment in symptomatic patients improves prognosis. We recommend administration of prophylactic multivitamins supplements in patients at risk as routine clinical practice. |
| format | Article |
| id | doaj-art-5d726f2065c242919ea5b0d48e0cbf1e |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-5d726f2065c242919ea5b0d48e0cbf1e2025-02-03T05:51:20ZengWileyCase Reports in Neurological Medicine2090-66682090-66762015-01-01201510.1155/2015/624807624807Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric PhytobezoarNuria Huertas-González0Virgilio Hernando-Requejo1Zaida Luciano-García2Juan Luis Cervera-Rodilla3Severo Ochoa Hospital, Leganés, 28911 Madrid, SpainSevero Ochoa Hospital, Leganés, 28911 Madrid, SpainSevero Ochoa Hospital, Leganés, 28911 Madrid, SpainSevero Ochoa Hospital, Leganés, 28911 Madrid, SpainBackground. Wernicke’s encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular symptoms, called “wet beriberi.” Association with folate deficit worsens the clinical picture. Subject. A 70-year-old man with gastric phytobezoar presented with gait instability, dyspnoea, chest pain associated with right heart failure and pericarditis, and folate deficiency. Furosemide was administered and cardiac symptoms improved but he soon developed vertiginous syndrome, nystagmus, diplopia, dysmetria, and sensitive and motor deficit in all four limbs with areflexia. Results. A cerebral magnetic resonance imaging (MRI) showed typical findings of WE. He was immediately treated with thiamine. Neurological symptoms improved in a few days and abnormal signals disappeared in a follow-up MRI two weeks later. Conclusion. Patients with malabsorption due to gastrointestinal disorders have an increased risk of thiamine deficiency, and folate deficiency can make this vitamin malabsorption worse. An established deficiency mainly shows neurological symptoms, WE, or rarely cardiovascular symptoms, wet beriberi. Early vitamin treatment in symptomatic patients improves prognosis. We recommend administration of prophylactic multivitamins supplements in patients at risk as routine clinical practice.http://dx.doi.org/10.1155/2015/624807 |
| spellingShingle | Nuria Huertas-González Virgilio Hernando-Requejo Zaida Luciano-García Juan Luis Cervera-Rodilla Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar Case Reports in Neurological Medicine |
| title | Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar |
| title_full | Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar |
| title_fullStr | Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar |
| title_full_unstemmed | Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar |
| title_short | Wernicke’s Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar |
| title_sort | wernicke s encephalopathy wet beriberi and polyneuropathy in a patient with folate and thiamine deficiency related to gastric phytobezoar |
| url | http://dx.doi.org/10.1155/2015/624807 |
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