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SMJ // Article

Case Report

Wernicke Encephalopathy Complicating Lymphoma Therapy: Case Report and Literature Review

Authors: Scott Boniol, MD, Molly Boyd, MD, Rachel Koreth, MD, Gary V. Burton, MD

Abstract

Thiamine deficiency can occur in any disease that results in inadequate intake or excessive loss of vitamin B1. In addition to increased thiamine consumption secondary to high cell turnover, cancer patients frequently have reduced oral intake as a direct result of their cancer or from cancer treatments. However, Wernicke encephalopathy (cerebral Beriberi), a clinical manifestation of thiamine deficiency, has rarely been associated with cancer patients. We report a case of Wernicke encephalopathy in a nonalcoholic patient with lymphoma. Although thiamine deficiency rarely potentiates clinical sequelae in cancer patients, it is important to recognize the risk and the clinical signs and manifestations so that prompt therapy can be initiated to reverse morbidity.


Key Points


* Wernicke encephalopathy is a reversible condition caused by thiamine deficiency.


* Thiamine deficiency occurs in any disease state that causes inadequate intake or excessive loss of vitamin B1.


* Wernicke encephalopathy manifests as encephalopathy, oculomotor dysfunction, and gait ataxia.


* Treatment of Wernicke encephalopathy requires intravenous thiamine prior to any glucose-containing solutions so as not to precipitate the disease.

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