| A Case of Wernicke's Encephalopathy which Occurred During
Chemotherapy in a Child with Acute Myeloblastic Leukemia |
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Sang-Nam Bae1, Bu-Jin Kim1, Seong-Shik Park1, Sang-Ook Nam1, Young-Tak Lim1, Hak-Jin Kim2 |
1Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea
2Department of Radiology, College of Medicine, Pusan National University, Pusan, Korea |
| 소아 급성 골수성 백혈병 환아에서 항암 화학 요법 중 발생한 Wernicke's Encephalopathy 1례 |
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배상남1, 김부진1, 박성식1, 남상욱1, 임영탁1, 김학진2 |
1부산대학교 의과대학 소아과학교실
2부산대학교 의과대학 진단방사선학교실 |
Correspondence:
Young-Tak Lim, Email: lymyt@hyowon.pusan.ac.kr
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| Abstract |
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Wernicke,s encephalopathy(WE), a neurological disorder caused by thiamine deficiency, is characterized by the triad of ocular symptoms, ataxia, and mental confusion. More than 90% of the cases are observed in chronic alcoholics. Other conditions less frequently associated with WE are anorexia nervosa, prolonged parenteral nutrition, hemodialysis, uremia, hyperemesis gravidarum, gastroplasty for morbid obesity, and acquired immunodeficiency syndrome(AIDS). One of the rare diseases associated with WE is tumors of the lymphoid-hemopoietic systems. We experienced a case of WE in a 15-year-old girl presented with bilateral horizontal nystagmus, bilateral abducens nerve palsy, mental confusion, disorientation, and ataxia after suffering anorexia, persistent vomiting, and watery diarrhea for 30 days following chemotherapy for acute myeloblastic leukemia. The serum thiamine level was 13.4 ng/mL(normal : 18.4-53.1). Brain MR T2-weighted image revealed a high signal intensity lesions bilaterally at the medial thalamus, pons, tectum, mammilary body, lateral wall of third ventricle, and putamen. Bilateral abducens nerve palsy, ataxia, and mental confusion improved dramatically following thiamine 100 mg/day replacement for 4 days. After two monthly follow-up, she was left with a residual fine bilateral horizontal nystagmus. We confirmed this case by clinical symptoms, brain MR findings, low thiamine level, and clinical response following thiamine replacement, and report with a brief review of the literature. |
| Key Words:
Wernicke's encephalopathy, Acute myeloblastic leukemia |
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