Wernicke encephalopathy in a lung cancer patient receiving home medical care
Wernicke encephalopathy in a lung cancer patient receiving home medical care
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DOI：
10.1017/s1478951521000900
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发表时间：
2021-08-01
影响因子：
2.2
通讯作者：
Onishi, Hideki
中科院分区：
文献类型：
--
作者：
Ito, Hiroshi;Ishida, Mayumi;Onishi, Hideki
目的 癌症患者通常希望在家度过最后的日子，全科医生必须具备与癌症医学和症状缓解相关的知识和技术技能。最近的临床研究表明，韦尼克脑病（WE）在癌症患者中相当常见。然而，迄今为止还没有关于接受家庭医疗护理的癌症患者的 WE 的报道。方法 从一系列接受家庭医疗护理的癌症患者中，我们报告了一名出现 WE 的肺癌患者。结果 一名 84 岁肺癌女性患者在接受家庭医疗护理时出现精神状态受损和注意力缺陷。她的症状符合谵妄的诊断标准。怀疑 WE 是因为患者的食物摄入量从一个月前的正常水平下降到 50% 或只有几口。血清硫胺素异常和服用硫胺素后谵妄消失支持了这一诊断。结果意义当癌症患者在家接受治疗时出现谵妄时，有必要怀疑硫胺素缺乏是潜在原因，适当的诊断和治疗可以预防不可逆的脑部相关后遗症。
Objective Cancer patients often want to spend their final days at home, and it is essential that general practitioners have knowledge of and technical skills related to cancer medicine and symptom relief. Recent clinical studies have revealed that Wernicke encephalopathy (WE) is quite common in cancer patients. However, there have been no reports to date on WE in cancer patients undergoing home medical care. Methods From a series of cancer patient undergoing home medical care, we reported a patient with lung cancer who developed WE. Results An 84-year-old female with lung cancer undergoing home medical care developed an impaired mental state and an attention deficit. Her symptoms fulfilled the diagnostic criteria for delirium. WE was suspected as the patient's food intake had fallen from normal a month previously to somewhere between 50% or just a few mouthfuls. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after thiamine administration. Significance of the results When delirium occurs in cancer patients undergoing home treatment, it is necessary to suspect thiamine deficiency as a potential cause, as appropriate diagnosis and treatment can prevent irreversible brain-related sequelae.