Korean J Hematol.  2001 Feb;36(1):95-99.

A Case of Iatrogenic Wernicke's Encephalopathy Following Chemotherapy and Total Parenteral Nutrition

• Hong SH
• Kim ES
• Roh YW
• Jung SK
• Chung C
• Kong HS
• Yun CB
• Kang SS
• Lee SK
• Hwang HY
• Bang SM
• Cho EK
• Shin DB
• Lee JH

Abstract

Wernicke's encephalopathy is a neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, persistent vomiting, hyperemesis gravidarum, anorexia nervosa and malnutrition. The classic triad of Wernicke's encephalopathy are ataxia, altered mentation and ophthalmoplegia. A 19-year-old boy had been treated with high dose Ara-C and mitoxantrone for acute myelogenous leukemia and intravenous hyperalimentation due to persistent vomiting. He suddenly complained of diplopia, gait disturbance and generalized weakness at 36th day after chemotherapy. Physical examinations showed disorientated mentality, oculomotor palsy and horizental nystagmus. The diagnosis of Wernicke's encephalopathy was made with classical brain MRI and decreased thiamine level. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after high dose Ara-C chemotherapy followed by intravenous hyperalimentation in a patient with acute myelogenous leukemia.

Keyword

Wernicke's encephalopathy; Thiamine deficiency; AML; Chemotherapy; Parenteral nutrition

MeSH Terms

Alcoholics
Anorexia Nervosa
Ataxia
Brain
Cytarabine
Diagnosis
Diplopia
Drug Therapy*
Female
Gait
Humans
Hyperemesis Gravidarum
Leukemia, Myeloid, Acute
Magnetic Resonance Imaging
Male
Malnutrition
Mitoxantrone
Ophthalmoplegia
Paralysis
Parenteral Nutrition
Parenteral Nutrition, Total*
Physical Examination
Pregnancy
Thiamine
Thiamine Deficiency
Vomiting
Wernicke Encephalopathy*
Young Adult
Cytarabine
Mitoxantrone
Thiamine