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[韦尼克脑病与干性脚气病;有精神病史患者接受减肥手术后的晚期并发症]

[Wernicke encephalopathy and dry beriberi; late complications after bariatric surgery performed on a patient with a psychiatric history].

作者信息

Penders G E M, Daey Ouwens I M, van der Heijden F M M A

出版信息

Tijdschr Psychiatr. 2017;59(2):116-120.

Abstract

A 38-year-old woman was admitted in a psychiatric hospital because of memory disorders. Dry beriberi and Korsakoff's syndrome, as a late neuropsychiatric manifestation of Wernicke's encephalopathy, were established. The beriberi symptoms decreased slowly, but the patient's memory impairments persisted. These clinical features were caused by a thiamine deficiency. Gastric bypass surgery is associated with an increased risk of thiamine deficiency. Excessive alcohol consumption and poor compliance with vitamin deficiency treatment both contributed to the rapid onset of these disorders. The case we describe demonstrates how important it is that patients who have undergone bariatric surgery are prescribed the correct vitamin supplements and that the treatment is continued for an appropriate period of time; this treatment is particularly important in the case of patients who are also suffering from an comorbid alcohol-related disorder.

摘要

一名38岁女性因记忆障碍入住精神病院。干性脚气病和科萨科夫综合征被确诊为韦尼克脑病的晚期神经精神表现。脚气病症状缓慢减轻,但患者的记忆障碍仍然存在。这些临床特征是由硫胺素缺乏引起的。胃旁路手术与硫胺素缺乏风险增加有关。过量饮酒和对维生素缺乏治疗依从性差均导致了这些疾病的快速发作。我们描述的这个病例表明,对接受过减肥手术的患者开具正确的维生素补充剂并持续适当时间的治疗是多么重要;对于同时患有酒精相关共病的患者,这种治疗尤为重要。

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