Neuropediatrics 2009; 40(5): 249-251
DOI: 10.1055/s-0030-1248244
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Wernicke's Encephalopathy during Total Parenteral Nutrition in a Child with Acute Lymphoblastic Leukemia and Acute Pancreatitis

S. Muwakkit1 , C. Al-Aridi1 , R. Saab1 , R. Hourani2 , N. Yazbeck1 , M. Abboud3
  • 1Department of Pediatrics, Medical Center, American University of Beirut, Beirut, Lebanon
  • 2Department of Radiology, Medical Center, American University of Beirut, Beirut, Lebanon
  • 3Children's Cancer Center, American University of Beirut, Beirut, Lebanon
Further Information

Publication History

received 30.10.2009

accepted 15.01.2010

Publication Date:
10 March 2010 (online)

Abstract

We herein describe a 16-year-old child with acute lymphoblastic leukemia and acute pancreatitis who developed Wernicke's encephalopathy secondary to prolonged total parenteral nutrition (TPN) that lacked vitamin B1 supplementation. The patient showed a direct and complete response to thiamine therapy. Diagnostic challenges are discussed and recommendations for prophylactic vitamin B1 supplementation in children with leukemia who are placed on TPN are made.

References

  • 1 Bleggi-Torres LF, de Medeiros BC, Werner B. et al . Neuropathological findings after bone marrow transplantation: an autopsy study of 180 cases.  Bone Marrow Transplant. 2000;  25 301-307
  • 2 Brück W, Christen HJ, Lakomek H. et al . Wernicke's encephalopathy in a child with acute lymphoblastic leukemia treated with polychemotherapy.  Clin Neuropathol. 1991;  10 134-136
  • 3 D’Aprile P, Tarantino A, Santoro N. et al . Wernicke's encephalopathy induced by total parenteral nutrition in patient with acute leukaemia: unusual involvement of caudate nuclei and cerebral cortex on MRI.  Neuroradiology. 2000;  42 781-783
  • 4 Knoderer HM, Robarge J, Flockhart DA. Predicting asparaginase-associated pancreatitis.  Pediatr Blood Cancer. 2007;  49 634-639
  • 5 Kuo SH, Debnam JM, Fuller GN. et al . Wernicke's encephalopathy: an underrecognized and reversible cause of confusional state in cancer patients.  Oncology. 2009;  76 10-18
  • 6 Miyajima Y, Fukuda M, Kojima S. et al . Wernicke's encephalopathy in a child with acute lymphoblastic leukemia.  Am J Pediatr Hematol Oncol. 1993;  15 331-334
  • 7 Onodera N, Nakahata T, Tanaka H. et al . Successful treatment of Wernicke's encephalopathy in a boy with acute mixed lineage leukemia.  Acta Paediatr Jpn. 1998;  40 271-274
  • 8 Sechi G, Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management.  Lancet Neurol. 2007;  6 442-455
  • 9 Shah N, Wolff JA. Thiamine deficiency: probable Wernicke's encephalopathy successfully treated in a child with acute lymphocytic leukemia.  Pediatrics. 1973;  51 750-751
  • 10 Sun GH, Yang YS, Liu QS. et al . Pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis: a clinical study.  World J Gastroenterol. 2006;  12 4224-4227
  • 11 Vanhulle C, Dacher JN, Delangre T. et al . Antineoplastic chemotherapy and Wernicke's encephalopathy.  Arch Pediatr. 1997;  4 243-246

Correspondence

Samar Muwakkit

Department of Pediatrics Medical Center

American University of Beirut

PB Box 11-0236

1107 2020 Beirut

Phone: +961/1/350 000

Fax: +961/1/366 384

Email: sm03@aub.edu.lb

    >