Wernicke's Encephalopathy that Developed during the Introduction Period of Peritoneal Dialysis

Yuko Nakashima; Kenji Ito; Hitoshi Nakashima; Aki Shirakawa; Yasuhiro Abe; Satoru Ogahara; Yoshie Sasatomi; Tomoe Yasunaga; Masakazu Ifuku; Jun Tsugawa; Yoshio Tsuboi; Takao Saito

doi:10.2169/internalmedicine.52.9427

CASE REPORTS

Wernicke's Encephalopathy that Developed during the Introduction Period of Peritoneal Dialysis

Yuko Nakashima, Kenji Ito, Hitoshi Nakashima, Aki Shirakawa, Yasuhiro Abe, Satoru Ogahara, Yoshie Sasatomi, Tomoe Yasunaga, Masakazu Ifuku, Jun Tsugawa, Yoshio Tsuboi, Takao Saito

Author information

Yuko Nakashima
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Kenji Ito
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Hitoshi Nakashima
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Aki Shirakawa
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Yasuhiro Abe
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Satoru Ogahara
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Yoshie Sasatomi
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Tomoe Yasunaga
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Masakazu Ifuku
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan
Jun Tsugawa
Division of Neurology, Faculty of Medicine, Fukuoka University, Japan
Yoshio Tsuboi
Division of Neurology, Faculty of Medicine, Fukuoka University, Japan
Takao Saito
Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Japan

Keywords: Wernicke's encephalopathy, thiamine, peritoneal dialysis, Korsakoff syndrome

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 18 Pages 2093-2097

DOI https://doi.org/10.2169/internalmedicine.52.9427

Details

Abstract

A 43-year-old man was admitted with end-stage renal disease caused by IgA nephropathy, and was treated with maintenance peritoneal dialysis. The patient developed general fatigue and appetite loss, and his symptoms were gradually aggravated by depression. After approximately 2 months on dialysis, the patient presented with altered consciousness and ophthalmoplegia. Wernicke's encephalopathy was diagnosed based on the presence of classic symptoms and the findings on magnetic resonance imaging. Thiamine replacement therapy was immediately initiated. The patient recovered from most of his neurological symptoms; however, the sequela of Korsakoff syndrome remained. A marginal thiamine deficiency in combination with predisposing factors must be considered when treating dialysis patients.

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