Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T03:30:11.670Z Has data issue: false hasContentIssue false
  • English
  • Français

Subclinical thiamine deficiency identified by preoperative evaluation in an ovarian cancer patient: Diagnosis and the need for preoperative thiamine measurement

Published online by Cambridge University Press:  31 August 2018

Hideki Onishi ,
Mayumi Ishida ,
Nozomu Uchida ,
Daisuke Shintani ,
Tadaaki Nishikawa Open the ORCID record for Tadaaki Nishikawa [Opens in a new window] ,
Kosei Hasegawa ,
Keiichi Fujiwara  and
Tatsuo Akechi
Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Daisuke Shintani
Affiliation:
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Tadaaki Nishikawa
Affiliation:
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Kosei Hasegawa
Affiliation:
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Keiichi Fujiwara
Affiliation:
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Tatsuo Akechi
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
*
Author for correspondence: Hideki Onishi, M.D., Ph.D., Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. E-mail: honishi@saitama-med.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Although thiamine deficiency (TD) and Wernicke encephalopathy (WE) are not rare in cancer patients, the cases reported to date developed TD and/or WE after treatment had started.

Method

From a series of cancer patients, we report a patient diagnosed with TD without the typical clinical symptoms of WE at the preoperative psychiatric examination.

Result

A 43-year-old woman with ovarian cancer was referred by her oncologist to the psycho-oncology outpatient clinic for preoperative psychiatric evaluation. Her tumor had been growing rapidly before the referral. Although she did not develop delirium, cerebellar signs, or eye symptoms, we suspected she might have developed TD because of her 2-month loss of appetite as the storage capacity of thiamine in the body is approximately 18 days. The diagnosis of TD was supported by abnormally low serum thiamine levels.

Significance of results

Cancer therapists need to be aware that thiamine deficiency may occur even before the start of cancer treatment. In cases with a loss of appetite of more than 2 weeks’ duration, in particular, thiamine deficiency should be considered if the tumor is rapidly increasing, regardless of the presence or absence of delirium.

Keywords

Thiamine deficiencyWernicke encephalopathyOvarian cancerDeliriumVitamin B1
Type
Case Report
Information
Palliative & Supportive Care , Volume 17 , Issue 5 , October 2019 , pp. 609 - 610
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Isenberg-Grzeda, E, Alici, Y, Hatzoglou, V, Nelson, C and Breitbart, W (2016a). Nonalcoholic thiamine-related encephalopathy (Wernicke-Korsakoff syndrome) among inpatients with cancer: A series of 18 cases. Psychosomatics 57(1), 71–81.Google Scholar
Isenberg-Grzeda, E, Hsu, AJ, Hatzoglou, V, Nelso, C and Breitbart, W (2014) Palliative treatment of thiamine-related encephalopathy (Wernicke's encephalopathy) in cancer: A case series and review of the literature. Palliative and Supportive Care, 1–9.Google Scholar
Isenberg-Grzeda, E, Rahane, S, DeRosa, AP, Ellis, J and Nicolson, SE (2016b) Wernicke-Korsakoff syndrome in patients with cancer: A systematic review. Lancet Oncology 17(4), e142–e148.Google Scholar
Isenberg-Grzeda, E, Shen, MJ, Alici, Y, Wills, J, Nelson, C and Breitbart, W (2017) High rate of thiamine deficiency among inpatients with cancer referred for psychiatric consultation: Results of a single site prevalence study. Psychooncology 26(9), 1384–1389.Google Scholar
MacLean, LD, Rhode, BM and Shizgal, HM (1983) Nutrition following gastric operations for morbid obesity. Annals of Surgery 198(3), 347–355.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, Takahashi, T, Taji, Y, Ikebuchi, K, Furuya, D and Akechi, T (2017) Subclinical thiamine deficiency in patients with abdominal cancer. Palliative and Supportive Care, 1–3 [Epub ahead of print].Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, Takahashi, T, Taji, Y, Ikebuchi, K, Furuya, D and Akechi, T (2018) Wernicke encephalopathy without delirium in patients with cancer. Palliative and Supportive Care 16(1), 118–121.Google Scholar
Onishi, H, Ishida, M, Toyama, H, Tanahashi, I, Ikebuchi, K, Taji, Y, Fujiwara, K and Akechi, T (2016) Early detection and successful treatment of Wernicke encephalopathy in a patient with advanced carcinoma of the external genitalia during chemotherapy. Palliative and Supportive Care 14(3), 302–306.Google Scholar
Onishi, H, Kawanishi, C, Onose, M, Yamada, T, Saito, H, Yoshida, A and Noda, K (2004) Successful treatment of Wernicke encephalopathy in terminally ill cancer patients: Report of 3 cases and review of the literature. Supportive Care in Cancer 12(8), 604–608.Google Scholar
Onishi, H, Sugimas, Y, Kawanishi, C and Onose, M (2005) Wernicke encephalopathy presented in the form of postoperative delirium in a patient with hepatocellular carcinoma and liver cirrhosis: A case report and review of the literature. Palliative and Supportive Care 3(4), 337–340.Google Scholar
Sechi, G, Batzu, L, Agro, L and Fois, C (2016a) Cancer-related Wernicke-Korsakoff syndrome. Lancet Oncology 17(6), e221–e222.Google Scholar
Sechi, G, Sechi, E, Fois, C and Kumar, N (2016b) Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutrition Review 74(5), 281–300.Google Scholar
Sechi, G and Serra, A (2007) Wernicke's encephalopathy: New clinical settings and recent advances in diagnosis and management. Lancet Neurology 6(5), 442–455.Google Scholar
van Zaanen, HC and van der Lelie, J (1992) Thiamine deficiency in hematologic malignant tumors. Cancer 69(7), 1710–1713.Google Scholar