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 Dec;17(6):738-740. doi: 10.1017/S147895151900018X.
Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer. However, it has not been recognized to date in bereaved partners after spousal loss from cancer.
From a series of bereaved partners who lost a spouse to cancer, we report on those who developed TD after bereavement.
Case 1 was a 57-year-old woman who sought consultation at our "bereavement clinic." Her husband had been diagnosed with pancreatic cancer one year earlier and had died one month previously. At the first visit, she was observed to suffer depression, anxiety, and decreased appetite. Neurological, blood, and biochemical examinations did not reveal any noteworthy findings. She was diagnosed with uncomplicated bereavement. Detailed examination revealed that her appetite had been markedly decreased for approximately five weeks. The diagnosis of TD was supported by her abnormally low serum thiamine level. Case 2 was a bereaved 73-year-old male who had lost his wife to hypopharyngeal cancer one month previously after a five-year illness. He had shown a lack of energy for the month preceding his wife's death, but because there was no improvement after her death, his family recommended he seek consultation at our "bereavement clinic." He was suffering from major depressive disorder. Detailed examination revealed that his appetite had been decreased for more than two weeks. Again, the diagnosis of TD was supported by his abnormally low serum thiamine level.
These reports demonstrate that there is a possibility that bereaved could develop TD after the loss of a loved one. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of the bereaved to prevent complications because of TD.
维生素 B1 缺乏症（TD）在各种伴有食欲不振的疾病中都有发现，包括癌症。然而，目前尚未在因癌症丧偶的配偶中发现这种情况。
从一系列因癌症丧偶的配偶中，我们报告了那些在丧偶后出现 TD 的人。
病例 1 是一位 57 岁的女性，她因丧偶后出现抑郁、焦虑和食欲不振，前来我们的“丧亲诊所”就诊。她的丈夫一年前被诊断患有胰腺癌，并在一个月前去世。在第一次就诊时，她表现出抑郁、焦虑和食欲不振。神经、血液和生化检查未发现任何明显异常。她被诊断为单纯性丧亲。详细检查发现，她的食欲明显下降约五周。血清硫胺素水平异常低支持 TD 的诊断。病例 2 是一位 73 岁的男性，他的妻子因下咽癌去世，在患病五年后一个月前去世。在他妻子去世前的一个月，他就表现出缺乏精力，但在她去世后没有改善，因此他的家人建议他来我们的“丧亲诊所”就诊。他患有重度抑郁症。详细检查发现，他的食欲下降已超过两周。同样，血清硫胺素水平异常低支持 TD 的诊断。
这些报告表明，丧偶者在失去亲人后有可能患上 TD。只要食欲不振持续超过 2 周，就应考虑 TD，并应注意丧亲者的身体状况，以防止因 TD 引起的并发症。
