Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan.
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan.
Palliat Support Care. 2023 Aug;21(4):768-771. doi: 10.1017/S1478951522001808.
Despite increasing reports of thiamine deficiency (TD) among cancer patients, there remain some patients with borderline thiamine concentrations (BTC). However, it is unclear whether such patients subsequently develop TD.
Here, we report cases of cancer patients progressing to TD within a short time period after presentation with BTC (24-28 ng/ml).
CASE 1: A 49-year-old female with lung cancer. During treatment for depression, the patient showed a decreased appetite, and a blood sample revealed BTC (25 ng/ml). Fourteen days later, she reported a continued loss of appetite, and despite the absence of the 3 classical signs of Wernicke encephalopathy (WE), additional testing showed a thiamine level of 23 ng/ml, leading to a diagnosis of TD.
CASE 2: A 65-year-old female developed depression during chemotherapy for angiosarcoma. Her blood sample revealed BTC (25 ng/ml). Seven days later, despite the absence of the classical signs of WE, a further testing revealed a thiamine level of 20 ng/ml.
CASE 3: A 41-year-old female developed depression during chemotherapy for ovarian cancer. No loss of appetite was observed, but a blood sample revealed BTC (25 ng/ml). Seven days later, despite the absence of the classical signs of WE or decreased appetite, further testing revealed a thiamine level of 19 ng/ml.
Depressed cancer patients with BTC may develop TD within a short time frame. To prevent TD, health-care professionals should maintain an awareness of its potential and the need for regular testing of thiamine level or prophylactic replacement therapy.
尽管越来越多的癌症患者出现硫胺素缺乏症（TD）的报告，但仍有一些患者的硫胺素浓度处于边缘状态（BTC）。然而，目前尚不清楚这些患者是否随后会发展为 TD。
在这里，我们报告了一些癌症患者在 BTC（24-28ng/ml）出现后短时间内发展为 TD 的病例。
病例 1：一名 49 岁女性，患有肺癌。在治疗抑郁症期间，患者出现食欲不振，血液样本显示 BTC（25ng/ml）。14 天后，她报告说食欲不振持续存在，尽管没有 WE 的 3 个经典迹象，但进一步的检查显示硫胺素水平为 23ng/ml，诊断为 TD。
病例 2：一名 65 岁女性在接受血管肉瘤化疗期间出现抑郁症。她的血液样本显示 BTC（25ng/ml）。7 天后，尽管没有 WE 的经典迹象，但进一步的检查显示硫胺素水平为 20ng/ml。
病例 3：一名 41 岁女性在接受卵巢癌化疗期间出现抑郁症。未观察到食欲不振，但血液样本显示 BTC（25ng/ml）。7 天后，尽管没有 WE 的经典迹象或食欲不振，但进一步的检查显示硫胺素水平为 19ng/ml。
BTC 的抑郁癌症患者可能在短时间内发展为 TD。为了预防 TD，医疗保健专业人员应意识到其潜在风险，并需要定期检查硫胺素水平或预防性替代治疗。
