A case of Wernicke's encephalopathy associated with the introduction of hemodialysis
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- Kinashi Hiroshi
- Department of Nephrology, Komaki City Hospital
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- Yoshioka Tomoki
- Department of Nephrology, Komaki City Hospital
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- Urahama Yoshimichi
- Department of Nephrology, Komaki City Hospital
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- Iida Yoshiyasu
- Department of Nephrology, Komaki City Hospital
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- Masamoto Daijiro
- Department of Nephrology, Handa City Hospital
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- Nishimura Hayato
- Department of Nephrology, Handa City Hospital
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- Watanabe Midoriko
- Department of Nephrology, Handa City Hospital
Bibliographic Information
- Other Title
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- 血液透析導入時にWernicke脳症を合併した1例
- 症例報告 血液透析導入時にWernicke脳症を合併した1例
- ショウレイ ホウコク ケツエキ トウセキ ドウニュウジ ニ Wernicke ノウショウ オ ガッペイ シタ 1レイ
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Description
The patient was a 74-year-old woman with chronic renal failure being treated conservatively. The cause of renal failure might be renal sclerosis. She had complained of nausea and anorexia since October 2007. She was admitted to Handa City Hospital due to the progression of renal failure on October 23, 2007. On admission, serum levels of blood urea nitorogen (BUN), creatinine (Cr), and bicarbonate (HCO3-) were 64.1mg/dL, 5.14mg/dL, and 13.2mmol/L, respectively. There was no abdominal pain and no signs of severe lesion on abdominal ultrasonograph. Only chronic gastritis was detected in the endoscopy. Her serum levels of BUN and Cr were elevated to 80.4mg/dL and 6.38mg/dL on the third day after admission. Hemodialysis was started for uremia on the fourth day. However, her complaint did not improve and poor sight and unclearness appeared. Consciousness gradually became somnolent, so magnetic resonance imaging (MRI) of the brain was performed on the 8th day. T2, FLAIR, and diffusion-weighted MRI showed high-signal-intensity areas in the periaqueduct, over the mamillary bodies, and inside the thalamus, which was a characteristic finding of Wernicke's encephalopathy. Thiamine treatment was immediately initiated, and consciousness promptly improved. Later, a low plasma thiamine level of 14ng/mL (normal range 20-50 ng/mL) was demonstrated. She was treated with regular hemodialysis and rehabilitation, then transferred to another hospital for rehabilitation on the 57th day. The cause of Wernicke's encephalopathy was considered to be in adequate nutrition due to diet therapy and uremia, coupled with the loss of water-soluble vitamins during the dialysis procedure.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 42 (5), 379-385, 2009
The Japanese Society for Dialysis Therapy
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Keywords
Details 詳細情報について
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- CRID
- 1390282679656212480
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- NII Article ID
- 10024930907
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 10325010
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed