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[Wernicke encephalopathy in childhood osteosarcoma]
R Kálmánchey1, E Magyarossi, K Majtényi
1Semmelweis Orvostudományi Egyetem, II. sz. Gyermekklinikája, Budapest.
Insights
Wernicke encephalopathy, a rare neurological disorder, can occur in children undergoing chemotherapy for osteosarcoma. Prompt treatment with parenteral thiamine is crucial for recovery and survival, as untreated cases can be fatal.
Area of Science:
- Pediatric Oncology
- Neurology
- Nutritional Deficiencies
Background:
- Chemotherapy for osteosarcoma can present complex challenges in pediatric patients.
- Wernicke encephalopathy is a serious neurological condition often associated with thiamine deficiency.
Observation:
- Two pediatric osteosarcoma patients developed Wernicke encephalopathy symptoms, including vomiting, during chemotherapy.
- One patient experienced fatal toxic cardiomyopathy, with autopsy confirming Wernicke encephalopathy.
- The second patient presented with ocular signs, ataxia, and somnolence, indicative of encephalopathy.
Findings:
- Parenteral thiamine administration led to the recovery of the second patient from Wernicke encephalopathy.
- The study highlights the potential for Wernicke encephalopathy to manifest during cancer treatment in children.
- Autopsy findings in the deceased child confirmed Wernicke encephalopathy as the cause of death.
Implications:
- Early recognition and diagnosis of Wernicke encephalopathy in pediatric cancer patients are critical.
- Parenteral thiamine is a potentially life-saving treatment for this neurological complication.
- This emphasizes the importance of monitoring nutritional status and neurological signs during intensive pediatric cancer therapy.
Abstract:
Two children with osteosarcoma are presented in whom Wernicke encephalopathy with vomiting occurred during the chemotherapy. One of the children died with symptoms of toxic cardiomyopathy. Autopsy revealed Wernicke encephalopathy. The other child had similar symptoms (ocular signs, ataxia, somnolence). Parenteral thiamine had been given and after this therapy the child recovered from the encephalopathy. The authors emphasize the importance of the recognition of this neurological disorder occurring rarely in childhood: it can be cured with parenteral thiamine. Without thiamine treatment this condition is lethal.