title: Development of Wernicke's encephalopathy during initiation of hemodialysis in an elderly non-alcoholic patient.
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.
authors.affiliation: Department of Nephrology and Kidney Center, Iizuka Hospital, Iizuka City, Kyushu University, Fukuoka City, Japan. kimhiro2004@yahoo.co.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Takeda
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Muto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Mukai
authors.forename: Masahide
authors.initials: M
authors.lastname: Furusho
authors.forename: Satsuki
authors.initials: S
authors.lastname: Nakashita
authors.forename: Shuhei
authors.initials: S
authors.lastname: Miura
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Maeda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D014899:Wernicke Encephalopathy / Q000175:diagnosis / Q000209:etiology*