Subclinical thiamine deficiency in patients with abdominal cancer

Abstract

From 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.

Acetate Production from Glucose and Coupling to Mitochondrial Metabolism in Mammals

“…Under typical cell culture conditions when there is active PDH and aKGDH, ROS only contributes to around 5-15% of the acetate production (Figure 2). However, thiamine deficiency is reported to be a common occurrence in cancer patients providing additional context (Isenberg-Grzeda et al, 2017; Onishi et al, 2017; Sechi et al, 2016). Thiamine starvation and the addition of exogeneous ROS greatly stimulated the ROS contribution to acetate production (Figure 4G), which can be used to replenish intracellular acetyl groups.…”

Wernicke encephalopathy without delirium that appeared as agitation in a patient with lung cancer

“…A comparison of this case with the findings presented in a recent systematic review (Isenberg-Grzeda et al, 2016b) reveals that this case has two characteristic features: the first is that the agitation appeared as an isolated symptom, and the second is that the patient showed none of the classical symptoms of WE. These features indicate the diversity of clinical symptoms associated with WE and that the diagnosis of WE cannot be based on the typical clinical symptoms of WE alone, as we and another group have repeatedly emphasized (Isenberg-Grzeda et al, 2016b; Onishi et al, 2017a).…”

“…Most clinical cases of WE are recognized when patients develop delirium; however, little is known about the clinical features of WE in cases without delirium (Onishi et al, 2017a, 2017b).…”

Brachytherapy of tongue carcinoma in a patient with difficult airway: anesthetic considerations

“…Patients with chronic alcohol consumption, acute metabolic stress, and malignancy have higher risk of developing thiamine deficiency. Thiamine is not synthesized in the human body and requires continuous dietary intake [7]. Chronic alcohol consumption interferes thiamine absorption from the digestive system.…”