Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan.
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan.
Palliat Support Care. 2019 Oct;17(5):609-610. doi: 10.1017/S1478951518000615.
Although thiamine deficiency (TD) and Wernicke encephalopathy (WE) are not rare in cancer patients, the cases reported to date developed TD and/or WE after treatment had started.
From a series of cancer patients, we report a patient diagnosed with TD without the typical clinical symptoms of WE at the preoperative psychiatric examination.
A 43-year-old woman with ovarian cancer was referred by her oncologist to the psycho-oncology outpatient clinic for preoperative psychiatric evaluation. Her tumor had been growing rapidly before the referral. Although she did not develop delirium, cerebellar signs, or eye symptoms, we suspected she might have developed TD because of her 2-month loss of appetite as the storage capacity of thiamine in the body is approximately 18 days. The diagnosis of TD was supported by abnormally low serum thiamine levels.
Cancer therapists need to be aware that thiamine deficiency may occur even before the start of cancer treatment. In cases with a loss of appetite of more than 2 weeks' duration, in particular, thiamine deficiency should be considered if the tumor is rapidly increasing, regardless of the presence or absence of delirium.
尽管癌症患者中并不罕见硫胺素缺乏症（TD）和韦尼克脑病（WE），但迄今为止报告的病例是在治疗开始后出现 TD 和/或 WE。
我们从一系列癌症患者中报告了一例在术前精神科检查时诊断为 TD 而无 WE 典型临床症状的患者。
一名 43 岁女性，患有卵巢癌，她的肿瘤在转诊前迅速生长。尽管她没有出现意识模糊、小脑征或眼部症状，但我们怀疑她可能已经发生 TD，因为她已经有 2 个月食欲不振，而硫胺素在体内的储存量大约为 18 天。TD 的诊断得到了血清硫胺素水平异常低的支持。
癌症治疗师需要意识到，即使在开始癌症治疗之前，也可能发生硫胺素缺乏症。在食欲不振超过 2 周的情况下，如果肿瘤快速增长，无论是否存在意识模糊，都应考虑硫胺素缺乏症。
