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J Emerg Med 2021 Apr 6. Epub 2021 Apr 6.

Department of Emergency Medicine, University of California, San Diego, San Diego, California; Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, San Diego, California.

Background: Thiamine deficiency is an uncommon cause of severe illness in the United States that can lead to significant morbidity because of high-output cardiac failure, peripheral neuropathy, and permanent neurologic impairment. We report the case of a middle-aged woman with extreme malnutrition caused by complications of Roux-en-Y gastric bypass (RYGB) surgery who presented with signs and symptoms of severe thiamine deficiency and septic shock.

Case Report: A 43-year-old woman who had undergone RYGB surgery and who had multiple complications presented to the emergency department with agitation, confusion, and lethargy. Read More

Brain Behav Immun Health 2021 Mar 31:100252. Epub 2021 Mar 31.

Laboratory of Psychoneuroimmunology, Psychosomatic Research Center, Oral Oncology Center, Araçatuba Dental School, São Paulo State University - UNESP, Araçatuba, São Paulo, Brazil.

Encephalopathy is one of the most frequent neurological complications of severe Coronavirus Disease 2019 (COVID-19) patients. Cytokine storm and sepsis, hypercatabolic states, the use of furosemide and dialytic therapy represent risk factors for thiamine deficiency and are also found in patients with severe COVID-19. In this retrospective case series, we report clinical and neurological findings of fifteen patients with COVID-19-associated Wernicke Encephalopathy (WE) and their response to treatment with intravenous thiamine. Read More

Biochem Biophys Res Commun 2021 Mar 30;555:7-12. Epub 2021 Mar 30.

Division of Molecular Imaging, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.

Vitamine B thiamine is an essential component for glucose metabolism and energy production. The disulfide derivative, thiamine tetrahydrofurfuryl disulfide (TTFD), is more absorbent compared to readily-available water-soluble thiamine salts since it does not require the rate-limiting transport system required for thiamine absorption. However, the detailed pharmacokinetics of thiamine and TTFD under normal and pathological conditions were not clarified yet. Read More

Neurohospitalist 2021 Apr 4;11(2):141-147. Epub 2020 Sep 4.

Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Philippines.

Background: Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke's encephalopathy (WE), which may be associated with hyperemesis gravidarum (HEG).

Case Presentation: We present a case of a 36-year-old Filipino woman in her first trimester with HEG, along with the WKS triad and abnormal hyperintense signals in the bilateral thalami and midbrain, left occipital lobe, periaqueductal gray matter and pontine periventricular areas. Neurologic deficits partially improved but persisted despite intravenous thiamine administration. Read More

Am J Drug Alcohol Abuse 2021 Mar 29:1-7. Epub 2021 Mar 29.

Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA.

Alcohol use disorder (AUD) is associated with thiamine deficiency and Wernicke-Korsakoff Syndrome (WKS). Thiamine supplementation for the prevention of WKS in patients with suspected AUD in the Emergency Department (ED) is generally recommended. As alcohol-related diagnoses are frequent reasons for visits to EDs, ED thiamine prescribing practices are relevant to the overall management and prevention of WKS in patients with AUD. Read More