Corso Lucia, Lucaccioni Laura, Buttera Martina, De Agostini Mattia, Bergonzini Patrizia, Spezia Elisabetta, Caramaschi Elisa, Biondini Diego, Durante Viviana, Iughetti Lorenzo, Predieri Barbara
Postgraduate School of Paediatrics, University of Modena and Reggio Emilia, Modena, Italy.
Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Ital J Pediatr. 2025 Jul 21;51(1):240. doi: 10.1186/s13052-025-02022-7.
Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine (vitamin B1) deficiency. This encephalopathy is typically suspected in alcoholics adults, but it is important to remember that other less known and suspected causes can determine the development of the non-alcoholic Wernicke's encephalopathy. In non-alcoholic patients, the primary causes of Wernicke's encephalopathy include hyperemesis gravidarum, restrictive diets and malnutrition, cancer, post-operative complications following bariatric surgery. Few data are reported regarding non-alcoholic thiamine deficiency, especially within the paediatric population. We describe the case of an 11-year-old Caucasian male with obesity who experienced prolonged emesis after the beginning of a strictly hypocaloric dietary regimen. This resulted in biliary colic episodes and subsequent necessity for cholecystectomy. The day after surgery, the patient developed acute visual impairment, horizontal nystagmus and diplopia, which were attributed to thiamine deficiency. Wernicke's encephalopathy was suspected, so a blood sample was immediately collected to assay thiamine levels and empiric thiamine supplementation was started. Already from the day after the beginning of the treatment, the patient showed a significant improvement in his clinical conditions. This case study delineates clinical presentation, diagnosis, and treatment of our patient and provides information regarding the red-flag risk factors of non-alcoholic Wernicke's encephalopathy in children. The aim is to increase the likelihood of suspecting the diagnosis and to promptly start the therapy, which is both simple and lifesaving.
韦尼克-科尔萨科夫综合征是一种由硫胺素（维生素B1）缺乏引起的神经障碍。这种脑病通常在成年酗酒者中被怀疑，但重要的是要记住，其他不太为人所知且被怀疑的病因也可导致非酒精性韦尼克脑病的发生。在非酒精性患者中，韦尼克脑病的主要病因包括妊娠剧吐、限制性饮食和营养不良、癌症、减肥手术后的术后并发症。关于非酒精性硫胺素缺乏的报道很少，尤其是在儿科人群中。我们描述了一名11岁肥胖白人男性的病例，该患者在开始严格低热量饮食方案后出现了长期呕吐。这导致了胆绞痛发作以及随后进行胆囊切除术的必要性。手术后第二天，患者出现急性视力损害、水平眼球震颤和复视，这些症状被归因于硫胺素缺乏。怀疑为韦尼克脑病，因此立即采集血样检测硫胺素水平，并开始经验性补充硫胺素。从治疗开始后的第二天起，患者的临床状况就有了显著改善。本病例研究描述了我们患者的临床表现、诊断和治疗，并提供了有关儿童非酒精性韦尼克脑病警示风险因素的信息。目的是增加怀疑诊断的可能性，并迅速开始既简单又挽救生命的治疗。
