Uruha Akinori, Shimizu Toshio, Katoh Tomoji, Yamasaki Yasushi, Matsubara Shiro
Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042, Japan.
Case Rep Med. 2011;2011:156104. doi: 10.1155/2011/156104. Epub 2011 Jun 28.
We report a 74-year-old man with Wernicke's encephalopathy (WE) whose only prior illness was peptic ulcer disease. Upper gastrointestinal endoscopy demonstrated gastric ulcer scars accompanied by marked deformity, without pathologic evidence of malignancy. WE due to peptic ulcer disease in previous reports was substantially associated with thiamine deficiency due to recurrent vomiting or surgical procedures. In our case, however, there was no history of vomiting or gastrointestinal surgery. Besides, we thoroughly ruled out other known clinical settings related to WE. There is the possibility that peptic ulcer disease itself provoked thiamine deficiency due to malabsorption.
我们报告了一名74岁患有韦尼克脑病（WE）的男性，他之前唯一的疾病是消化性溃疡病。上消化道内镜检查显示胃溃疡瘢痕伴有明显畸形，无恶性病变的病理证据。既往报道中，因消化性溃疡病导致的WE主要与反复呕吐或外科手术引起的硫胺素缺乏有关。然而，在我们的病例中，没有呕吐或胃肠道手术史。此外，我们彻底排除了与WE相关的其他已知临床情况。消化性溃疡病本身因吸收不良引发硫胺素缺乏是有可能的。
