Wernicke's encephalopathy secondary to hyperthyroidism and ingestion of thiaminase-rich products

Ventura, Alessandro; Mafe, M.C.; Bourguet, Marie-Noëlle; Tornero, Carlos

doi:10.1016/j.nrleng.2012.01.003

Cited by 1 publication

(2 citation statements)

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“…Thiaminase is an enzyme that breaks down thiamine in food. Freshwater fish, raw shellfish, and ferns are rich in thiaminase, and people who consume them in high amount are at a higher risk of developing thiamine deficiency (6,13).…”

Section: Discussionmentioning

confidence: 99%

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Thyrotoxicosis With Development of Wernicke Encephalopathy in an Adolescent

Deeb

Qadry

Memari

et al. 2016

AACE Clinical Case Reports

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Objective: Wernicke encephalopathy (WE) is a rare disorder resulting from deficiency of thiamine (vitamin B1). It is precipitated by conditions including thyrotoxicosis, hyperemesis gravidarum, and alcoholism. The disease is not always suspected in pediatric patients, and its presentation can be atypical, so it is often underdiagnosed.Methods: We present a case of severe WE in a 13-yearold female that was precipitated by malnutrition secondary to vomiting, abdominal pain, and weight loss due to gastritis. Features of WE were induced by concomitant untreated hyperthyroidism. The patient showed the classical triad of WE clinically and had typical brain magnetic resonance imaging features.Results: Encephalopathy was dramatically improved after thiamine replacement. Her disease course ended with full reversal of neurologic deficits and radiologic abnormalities within 7 weeks.Conclusion: WE is a debilitating condition that can be life-threatening if not treated. It is underdiagnosed in children but can present with classical clinical and radiological features that should prompt the diagnosis. As with adults, untreated hyperthyroidism with a malnutrition state can lead to WE in children, and thiamine replacement can reverse the condition. (AACE Clinical Case Rep. 2016;2:e217-e220) Abbreviations: MRI = magnetic resonance imaging; NR = normal range; WE = Wernicke encephalopathy e218 Adolescent Wernicke Encephalopathy, AACE Clinical Case Rep. 2016;2(No. 3)

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Section: Discussionmentioning

confidence: 99%

“…Vague initial symptoms delay the diagnosis, and the disease can present with atypical features (5). WE is reportedly commonly induced by malnutrition in the presence of pathologic states like thyrotoxicosis (6)(7)(8), alcoholism (9), and hyperemesis gravidarum (10). These typical predisposing states are uncommon or not seen in children.…”

Section: Introductionmentioning

confidence: 99%