Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Wernicke's encephalopathy in a child with high dose thiamine therapy

  • Park, So Won (Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine) ;
  • Yi, Yoon Young (Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Han, Jung Woo (Division of Pediatric Hemato-Oncology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kim, Heung Dong (Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine) ;
  • Lee, Joon Soo (Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine) ;
  • Kang, Hoon-Chul (Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine)
  • 투고 : 2013.04.09
  • 심사 : 2014.01.10
  • 발행 : 2014.11.10
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초록

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

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참고문헌

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피인용 문헌

  1. Thiamine Deficiency in Tropical Pediatrics: New Insights into a Neglected but Vital Metabolic Challenge vol.3, pp.None, 2016, https://doi.org/10.3389/fnut.2016.00016
  2. Wernicke’s Encephalopathy in a Child with Acute Lymphoblastic Leukemia vol.34, pp.1, 2014, https://doi.org/10.4274/tjh.2016.0044
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  4. Establishing a case definition of thiamine responsive disorders among infants and young children in Lao PDR: protocol for a prospective cohort study vol.10, pp.2, 2014, https://doi.org/10.1136/bmjopen-2019-036539
  5. Infantile thiamine deficiency in South and Southeast Asia: An age‐old problem needing new solutions vol.46, pp.1, 2014, https://doi.org/10.1111/nbu.12481
  6. Thiamine and phosphate esters concentrations in whole blood and serum of patients with alcohol use disorder: a relation with cognitive deficits vol.24, pp.7, 2014, https://doi.org/10.1080/1028415x.2019.1652438
  7. Thiamine deficiency disorders: a clinical perspective vol.1498, pp.1, 2014, https://doi.org/10.1111/nyas.14536
  8. Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal vol.1498, pp.1, 2014, https://doi.org/10.1111/nyas.14669