Korean J Gastroenterol.  2014 Sep;64(3):158-163. 10.4166/kjg.2014.64.3.158.

Two Cases of Wernicke's Encephalopathy That Developed during Total Parenteral Nutrition in Colon Cancer Patients Treated with 5-Fluorouracil-based Chemotherapy

• Cho KP
• Lee JS
• Seong JS
• Woo YM
• Cho YJ
• Jeong BJ
• Sohn JH
• Kim SJ

• KMID: 2160658
• DOI: http://doi.org/10.4166/kjg.2014.64.3.158

Abstract

Wernicke's encephalopathy (WE) caused by thiamine deficiency is an acute neurological disorder. Clinically, the classic triad of WE consists of ophthalmoplegia, ataxia, and mental status changes. Thiamine deficiency is known to occur commonly in chronic alcoholic patients. Sometimes, it can occur in patients after gastrointestinal surgery and in those with malabsorption. In addition, patients undergoing renal dialysis, suffering from hyperemesis gravidarum, receiving total parenteral nutrition (TPN), and being treated with chemotherapeutic agents are also prone to develop thiamine deficiency. Herein, we report two cases of WE that developed following simultaneous 5-fluorouracil (5-FU) chemotherapy and TPN in colon cancer patients which was successfully treated with thiamine administration.

Keyword

Wernicke encephalopathy; Thiamine; Total parenteral nutrition; Fluorouracil; Colonic neoplasms

MeSH Terms

Adult
Antimetabolites, Antineoplastic/*therapeutic use
Brain/radiography
Colonic Neoplasms/*drug therapy
Fluorouracil/*therapeutic use
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Parenteral Nutrition, Total
Thiamine/therapeutic use
Vitamin B Complex/therapeutic use
Wernicke Encephalopathy/*diagnosis/drug therapy
Antimetabolites, Antineoplastic
Fluorouracil
Thiamine
Vitamin B Complex