Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient

Hiroshi Kimura, Kazuhito Takeda, Yoshiharu Muto, Hideyuki Mukai, Masahide Furusho, Satsuki Nakashita, Shuhei Miura, Atsuhiro Maeda, Kazuhiko Tsuruya

Research output: Contribution to journalArticle

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Abstract

A 79-year-old man with chronic renal failure developed general fatigue and loss of appetite. He was diagnosed with endstage renal disease and was started on hemodialysis (HD). The symptoms improved immediately, but the mental status deteriorated gradually, reaching Glasgow Coma Scale (GCS) 5. Computed tomography showed no significant intracranial lesion, but magnetic resonance images showed symmetric high-intensity changes in the periaqueductal area, suggestive of Wernicke's encephalopathy (WE). He was immediately treated with intravenous infusion of thiamine. Five days later, the mental status level improved up to GCS 14, and the above MRI findings disappeared. To our knowledge, this is the first report describing the clinical outcome of a non-alcoholic patient who developed WE during initiation of HD. WE should be suspected in patients who are on chronic HD as well as those on initiation of HD with unexplained neurological abnormalities.

Original languageEnglish
Pages (from-to)487-491
Number of pages5
JournalClinical Nephrology
Volume78
Issue number6
DOIs
Publication statusPublished - Dec 31 2012

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Wernicke Encephalopathy
Renal Dialysis
Glasgow Coma Scale
Thiamine
Appetite
Intravenous Infusions
Chronic Kidney Failure
Fatigue
Magnetic Resonance Spectroscopy
Tomography
Kidney

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Kimura, H., Takeda, K., Muto, Y., Mukai, H., Furusho, M., Nakashita, S., ... Tsuruya, K. (2012). Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient. Clinical Nephrology, 78(6), 487-491. https://doi.org/10.5414/CN107182

Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient. / Kimura, Hiroshi; Takeda, Kazuhito; Muto, Yoshiharu; Mukai, Hideyuki; Furusho, Masahide; Nakashita, Satsuki; Miura, Shuhei; Maeda, Atsuhiro; Tsuruya, Kazuhiko.

In: Clinical Nephrology, Vol. 78, No. 6, 31.12.2012, p. 487-491.

Research output: Contribution to journalArticle

Kimura, H, Takeda, K, Muto, Y, Mukai, H, Furusho, M, Nakashita, S, Miura, S, Maeda, A & Tsuruya, K 2012, 'Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient', Clinical Nephrology, vol. 78, no. 6, pp. 487-491. https://doi.org/10.5414/CN107182
Kimura, Hiroshi ; Takeda, Kazuhito ; Muto, Yoshiharu ; Mukai, Hideyuki ; Furusho, Masahide ; Nakashita, Satsuki ; Miura, Shuhei ; Maeda, Atsuhiro ; Tsuruya, Kazuhiko. / Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient. In: Clinical Nephrology. 2012 ; Vol. 78, No. 6. pp. 487-491.
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