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Wernicke encephalopathy in a lung cancer patient receiving home medical care

Published online by Cambridge University Press:  23 July 2021

Hiroshi Ito ,
Mayumi Ishida Open the ORCID record for Mayumi Ishida [Opens in a new window] ,
Kumi Itami ,
Akira Yoshioka ,
Izumi Sato ,
Nozomu Uchida Open the ORCID record for Nozomu Uchida [Opens in a new window] ,
Nobuyuki Onizawa  and
Hideki Onishi Open the ORCID record for Hideki Onishi [Opens in a new window]
Hiroshi Ito
Affiliation:
Ito Internal Medicine and Pediatric Clinic, Fukuoka, Japan
Mayumi Ishida*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Kumi Itami
Affiliation:
Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
Akira Yoshioka
Affiliation:
Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, Japan
Izumi Sato
Affiliation:
Department of Clinical Epidemiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Nobuyuki Onizawa
Affiliation:
Department of General Medicine, Anz clinic, Saitama, Japan
Hideki Onishi
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Mayumi Ishida, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. E-mail: [email protected]
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Abstract

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.

Keywords

CancerDeliriumHome careThiamine deficiencyWernicke encephalopathy
Type
Case Report
Information
Palliative & Supportive Care , Volume 19 , Issue 4 , August 2021 , pp. 501 - 503
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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