意識変容を呈した患者におけるチアミン欠乏症の特定と管理:1つの症例を見て、1つのB1を投与し、1つを治療する
Michael Freddy1, Tyler B Larsen2,3, Satya Patel3,4
1Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
Abstract:
Nutritional deficiencies in the United States are relatively uncommon due to federal regulations surrounding the fortification of food. As a result, the clinical syndromes that result from nutritional deficiencies are not commonly seen, making them less likely to be encountered in the clinical setting. Thiamine deficiency in particular is an important nutritional deficiency to consider, as the presentation is highly variable and can include encephalopathy and multiple neurologic findings. We present a case of altered mental status that appears to be Wernicke's encephalopathy due to the rapid improvement of symptoms with intravenous thiamine supplementation, corroborated by a low serum thiamine level. Assessing access to food is a critical piece of history in making this diagnosis, and early recognition can promote fully supplementing patients with thiamine to prevent ongoing thiamine deficiency and possible Korsakoff syndrome.
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