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非酒精性脚气病、韦尼克脑病与长期饮食失调:病例报告及文献综述

Non-alcoholic beriberi, Wernicke encephalopathy and long-term eating disorder: case report and a mini-review.

作者信息

Mantero Vittorio, Rifino Nicola, Costantino Gisella, Farina Andrea, Pozzetti Ugo, Sciacco Monica, Ripolone Michela, Bianchi Graziella, Salmaggi Andrea, Rigamonti Andrea

机构信息

Neurology Unit, "A. Manzoni" Hospital-ASST Lecco, Via dell'Eremo 9/11, 23900, Lecco, Italy.

Cardiology Unit, "A. Manzoni" Hospital-ASST Lecco, Lecco, Italy.

出版信息

Eat Weight Disord. 2021 Mar;26(2):729-732. doi: 10.1007/s40519-020-00880-0. Epub 2020 Mar 4.

Abstract

INTRODUCTION

Nowadays, reports of beriberi are rare in developed countries. Wernicke encephalopathy may be present in about 25% of patients with beriberi.

CASE REPORT

We report the case of a woman with history of depression and chronic eating disorder, who complained Wernicke encephalopathy and beriberi. Sural nerve and muscular biopsy were performed, showing severe axonal neuropathy. Thiamine supplementation was started with rapid improvement of the pulmonary and cardiac affections; improvement of peripheral neuropathy was incomplete.

CONCLUSIONS

Thiamine deficiency can be misdiagnosed. Beriberi is an important cause of acute flaccid paralysis; hence, clinicians should consider this diagnosis and prompt start thiamine treatment to avoid permanent neurological sequelae.

摘要

引言

如今,在发达国家脚气病的报告已很罕见。韦尼克脑病可能存在于约25%的脚气病患者中。

病例报告

我们报告一例有抑郁症和慢性饮食失调病史的女性,她主诉患有韦尼克脑病和脚气病。进行了腓肠神经和肌肉活检,显示严重的轴索性神经病。开始补充硫胺素后,肺部和心脏疾病迅速改善;周围神经病变的改善不完全。

结论

硫胺素缺乏可能被误诊。脚气病是急性弛缓性麻痹的重要原因;因此,临床医生应考虑这一诊断并迅速开始硫胺素治疗,以避免永久性神经后遗症。

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