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在一位接受减重胃袖状切除术的年轻女性患者中,韦尼克脑病酷似多发性硬化症。

Wernicke's encephalopathy mimicking multiple sclerosis in a young female patient post-bariatric gastric sleeve surgery.

作者信息

Lal Divya, Farrell Maureen C, Krishnamurthy Mahesh

机构信息

Easton Hospital, Easton, PA, USA.

Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

J Community Hosp Intern Med Perspect. 2021 Sep 20;11(5):658-661. doi: 10.1080/20009666.2021.1949792. eCollection 2021.

Abstract

We describe a case of Wernicke's encephalopathy secondary to thiamine (B1) deficiency in a patient status post-bariatric sleeve gastrectomy. The presenting symptoms of new-onset weakness, diplopia, and confusion in a young female patient raised suspicion for multiple sclerosis (MS), but given a history of bariatric surgery, thiamine levels were checked, revealing significant Vitamin B1 (thiamine) deficiency. This case highlights the importance of thorough history taking, as a misdiagnosis of MS in this case could have resulted in irreversible neurological deterioration and hematological and infectious consequences associated with the inappropriate administration of disease-modifying therapies. It is also important to note that severe vitamin deficiency occurred despite medication compliance.

摘要

我们描述了一例在接受减重袖状胃切除术后因硫胺素(维生素B1)缺乏继发韦尼克脑病的病例。一名年轻女性患者出现新发无力、复视和意识模糊的症状,引发了对多发性硬化症(MS)的怀疑,但鉴于其有减重手术史,对硫胺素水平进行了检查,结果显示维生素B1(硫胺素)严重缺乏。该病例突出了全面病史采集的重要性,因为在此病例中若误诊为MS,可能会导致不可逆的神经功能恶化以及因不适当使用疾病修正疗法而产生血液学和感染性后果。还需注意的是,尽管患者遵医嘱用药,但仍出现了严重的维生素缺乏。

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本文引用的文献

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Preventing Wernicke Encephalopathy After Bariatric Surgery.预防减重手术后韦尼克脑病。
Obes Surg. 2018 Jul;28(7):2060-2068. doi: 10.1007/s11695-018-3262-4.
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