Subclinical thiamine deficiency: What is the most appropriate method of diagnosis and treatment?
Subclinical thiamine deficiency: What is the most appropriate method of diagnosis and treatment?
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DOI：
10.1017/s147895152000098x
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发表时间：
2020-10-01
影响因子：
2.2
通讯作者：
Ishida, Mayumi
中科院分区：
文献类型：
--
作者：
Onishi, Hideki;Uchida, Nozomu;Ishida, Mayumi
目的硫胺素缺乏症的症状差异很大，无症状病例;即，已知存在亚临床硫胺素缺乏症（SCTD）。然而，有没有可用的治疗SCTD.MethodsWe报告的患者接受静脉内硫胺素替代治疗约一个月后，被诊断为SCTD，但谁开发的SCTD再次约三周后完成treatment.ResultsThe患者是一个64岁的女人谁，开始治疗宫颈癌后，抱怨焦虑，并进行了初步的精神检查。精神科的诊断是适应障碍。由于她的食欲下降和体重减轻导致SCTD并发症的可能性，测量了她的血清硫胺素浓度，发现其浓度较低。因此，静脉给予硫胺素29天。在治疗结束时，由于没有明显的神经精神症状或食欲问题，因此停用硫胺素。23天后，她的食欲和神经精神症状仍然没有问题，但随访血液样本显示，她的血清硫胺素再次低于正常范围。结果的意义目前，还没有关于癌症患者中SCTD的诊断和治疗的信息。在某些情况下，如本例，缺乏症复发，没有任何症状表明SCTD;因此，进一步检查诊断和治疗是必要的。
ObjectivesThe symptoms of thiamine deficiency vary considerably and asymptomatic cases; i.e., subclinical thiamine deficiency (SCTD), are known to exist. However, there is no information available on the treatment of SCTD.MethodsWe report a patient who underwent intravenous thiamine replacement therapy for about a month after being diagnosed with SCTD, but who developed SCTD again about three weeks after finishing the treatment.ResultsThe patient was a 64-year-old woman who, after starting treatment for cervical cancer, complained of anxiety and underwent an initial psychiatric examination. The psychiatric diagnosis was an adjustment disorder. Based on the possibility of SCTD complications due to her decreased appetite and weight loss, her serum thiamine concentration was measured and found to be low. Therefore, thiamine was administered intravenously for 29 days. At the end of treatment, thiamine administration was discontinued as there were no apparent neuropsychiatric symptoms or problems with appetite. Twenty-three days later, there were still no problems with appetite or neuropsychiatric symptoms, but a follow-up blood sample revealed that her serum thiamine was again below the normal range.Significance of resultsCurrently, there is no information available regarding the diagnosis and treatment of SCTD in cancer patients. In some cases, such as this case, the deficiency recurs without any symptoms indicative of SCTD; therefore, further examination for diagnosis and treatment is necessary.