一名患有严重急性胰腺炎的患者出现韦尼克脑病。
Wernicke encephalopathy presenting in a patient with severe acute pancreatitis.
作者信息
Arana-Guajardo Ana Cecilia, Cámara-Lemarroy Carlos Rodrigo, Rendón-Ramírez Erick Joel, Jáquez-Quintana Joel Omar, Góngora-Rivera Juan Fernando, Galarza-Delgado Dionicio Angel
机构信息
Department of Internal Medicine, University Hospital Dr José E González, Autonomous University of Nuevo León. Monterrey, NL, México.
出版信息
JOP. 2012 Jan 10;13(1):104-7.
CONTEXT
Acute pancreatitis can lead to prolonged fasting and malnutrition. Many metabolic changes, including thiamine deficiency, may lead to the well know pancreatic encephalopathy. In this condition however the thiamine deficiency is rarely suspected.
CASE REPORT
We report the case of a 17-year-old woman with severe acute pancreatitis who developed mental status changes and ophthalmoplegia. A magnetic resonance image showed hyperintensive signals in periventricular areas, medial thalamus, and mammillary bodies, findings consistent with the diagnosis of Wernicke encephalopathy. Thiamine treatment reversed neurological complications.
CONCLUSION
Wernicke encephalopathy secondary to thiamine deficiency should be considered as a possible cause of acute mental status changes in patients with acute pancreatitis and malnutrition. Prophylactic doses of thiamine could be considered in susceptible patients.
背景
急性胰腺炎可导致长期禁食和营养不良。许多代谢变化，包括硫胺素缺乏，可能导致众所周知的胰腺脑病。然而，在这种情况下，硫胺素缺乏很少被怀疑。
病例报告
我们报告了一名17岁患有严重急性胰腺炎的女性病例，该患者出现了精神状态改变和眼肌麻痹。磁共振成像显示脑室周围区域、内侧丘脑和乳头体有高强度信号，这些发现与韦尼克脑病的诊断一致。硫胺素治疗逆转了神经并发症。
结论
硫胺素缺乏继发的韦尼克脑病应被视为急性胰腺炎和营养不良患者急性精神状态改变的可能原因。对于易感患者，可考虑使用预防性剂量的硫胺素。
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