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Prolonged hypotension associated with Wernicke's encephalopathy

European Journal of Clinical Nutrition volume 72, pages 168–169 (2018)Cite this article

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Abstract

A diagnosis of Wernicke's encephalopathy (WE) is difficult. Transient hypotension has been reported as a rare complication of WE. We herein report a case of prolonged hypotension and dysuautonomia associated with WE in a 69-year-old man with underlying alcohol abuse. Without apparent etiology of shock, this patient remained hypotensive for 9 days, requiring a vasopressor, despite daily administration of thiamine 600 mg. Fluctuation of blood pressure caused by postural change and bradycardia in the presence of shock indicated that this patient had dysautonomia. This case hereby proposes a possible association between hypotension, dysautonomia and Wernicke's encephalopathy.

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References

  1. Sechi G, Serra A . Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007; 6: 442–455.

    Article  CAS  Google Scholar 

  2. Wang S, Hou X, Ding S, Guan Y, Zhen H, Tu L et al. Refractory hypotension in a patient with Wernicke's encephalopathy. Alcohol Alcohol 2012; 47: 48–51.

    Article  CAS  Google Scholar 

  3. Galvin R, Brathen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol 2010; 17: 1408–1418.

    Article  CAS  Google Scholar 

  4. Chen MH, Lee JT, Peng GS, Sung YF . Non-alcoholic Wernicke's encephalopathy as a cause of profound shock after abdominal surgery. QJM 2015; 108: 661–663.

    Article  Google Scholar 

  5. Long L, Cai XD, Bao J, Wu AM, Tian Q, Lu ZQ . Total parenteral nutrition caused Wernicke's encephalopathy accompanied by wet beriberi. Am J Case Rep 2014; 15: 52–55.

    Article  Google Scholar 

  6. Renthal W, Marin-Valencia I, Evans PA . Thiamine deficiency secondary to anorexia nervosa: an uncommon cause of peripheral neuropathy and Wernicke encephalopathy in adolescence. Pediatr Neurol 2014; 51: 100–103.

    Article  Google Scholar 

  7. Birchfield RI . Postural hypotension in Wernicke's disease. A manifestation of autonomic nervous system involvement. Am J Med 1964; 36: 404–414.

    Article  CAS  Google Scholar 

  8. Donnino MW, Carney E, Cocchi MN, Barbash I, Chase M, Joyce N et al. Thiamine deficiency in critically ill patients with sepsis. J Crit Care 2010; 25: 576–581.

    Article  CAS  Google Scholar 

  9. Thomson AD, Cook CC, Touquet R, Henry JA Royal College of Physicians L. The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and Emergency Department. Alcohol Alcohol 2002; 37: 513–521.

    Article  CAS  Google Scholar 

  10. Flannery AH, Adkins DA, Cook AM . Unpeeling the evidence for the banana bag: evidence-based recommendations for the management of alcohol-associated vitamin and electrolyte deficiencies in the ICU. Crit Care Med 2016; 44: 1545–1552.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Japan

    H Maeda

  2. Department of General Medicine, Kurashiki Central Hospital, Kurashiki, Japan

    A Kuriyama

  3. Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan

    T Tanaka

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  1. H Maeda
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  2. A Kuriyama
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  3. T Tanaka
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Correspondence to A Kuriyama.

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Maeda, H., Kuriyama, A. & Tanaka, T. Prolonged hypotension associated with Wernicke's encephalopathy. Eur J Clin Nutr 72, 168–169 (2018). https://doi.org/10.1038/ejcn.2017.141

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