![]() Yamada K, Furuya R, Takita T, Maruyama Y, Yamaguchi Y, Ohkawa S, et al. A new nutritional risk index for predicting mortality in hemodialysis patients: Nationwide cohort study. An update on non-thyroidal illness syndrome. Peripheral serum thyroxine, triiodothyronine and reverse triiodothyronine kinetics in the low thyroxine state of acute nonthyroidal illnesses. Kaptein EM, Robinson WJ, Grieb DA, Nicoloff JT. Anorexia in hemodialysis patients: an update. Appetite in chronic hemodialysis patients: a longitudinal study. Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. Wernicke’s encephalopathy associated with hemodialysis: report of two cases and review of the literature. Ihara M, Ito T, Yanagihara C, Nishimura Y. Analysis of possible causes of under-diagnosis. Underlying illness in Wernicke’s encephalopathy. Brain and behavioral pathology in an animal model of Wernicke’s encephalopathy and Wernicke-Korsakoff Syndrome. ![]() ![]() Vetreno RP, Ramos RL, Anzalone S, Savage LM. Effect of chronic kidney disease on the expression of thiamin and folic acid transporters. 2014 46(4):809–15.īukhari FJ, Moradi H, Gollapudi P, Ju Kim H, Vaziri ND, Said HM. Dietary intake of trace elements, minerals, and vitamins of patients on chronic hemodialysis. 2001 38(5):941–7.īossola M, Di Stasio E, Viola A, Leo A, Carlomagno G, Monteburini T, et al. Thiamine deficiency and unexplained encephalopathy in hemodialysis and peritoneal dialysis patients. Hung SC, Hung SH, Tarng DC, Yang WC, Chen TW, Huang TP. Neurological, psychiatric, and biochemical aspects of thiamine deficiency in children and adults. Thiamine and selected thiamine antivitamins-biological activity and methods of synthesis. Tylicki A, Łotowski Z, Siemieniuk M, Ratkiewicz A. Thus, NTIS might assist in the early detection of TD as an initial sign in HD patients. In the present case, TD manifested only as non-specific symptoms and was ultimately revealed by the presence of NTIS, which was resolved with thiamine supplementation. However, its non-specific initial symptoms, including decreases in appetite and liveliness, as well as undetectability in routine blood tests complicate early detection, resulting in underdiagnosis and more severe outcomes. HD patients are at a particularly high risk of thiamine deficiency (TD) and associated severe symptoms due to losses of thiamine during HD sessions. ![]() Thiamine injections of 100 mg at every HD treatment rapidly restored his appetite, liveliness, and NTIS findings. Additional examination disclosed low serum thiamine of 20 ng/mL. Brain magnetic resonance imaging to exclude the possibility of central hypothyroidism unexpectedly displayed slight abnormalities inside of the thalami that were characteristic of Wernicke’s encephalopathy. However, blood testing indicated non-thyroidal illness syndrome (NTIS) typically observed in patients with severe illness, with serum levels of thyroid stimulating hormone, free triiodothyronine, and free thyroxine of 0.17 μIU/mL, < 1.0 pg/mL, and 0.23 ng/dL, respectively. Physical examinations revealed no abnormalities. An 88-year-old male patient on maintenance hemodialysis (HD) therapy experienced gradual losses in appetite and liveliness during the course of 1 month.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |