title: Stem Cell Transplant-Associated Wernicke Encephalopathy in a Patient with High-Risk Neuroblastoma.
abstract: Children undergoing intense cancer treatment frequently require total parenteral nutrition (TPN). Rarely, vitamins are removed due to hypersensitivity to the carrier vehicle in the formulation. We present the case of a 5-year-old patient with stage 4, high-risk neuroblastoma who developed altered mental status, ataxia, and tachycardia during consolidative autologous stem cell transplantation. Skin findings and brain MRI were consistent with thiamine (vitamin B1) deficiency and Wernicke encephalopathy. Vitamin B1 administration rapidly reversed all skin and neurologic symptoms. This case highlights the importance of close monitoring of micronutrients in pediatric patients receiving prolonged courses of chemotherapy and stem cell transplantation.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology/Stem Cell Transplantation, Comer Children's Hospital, University of Chicago, Chicago, Illinois.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Darlington
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology/Stem Cell Transplantation, Comer Children's Hospital, University of Chicago, Chicago, Illinois.
authors.forename: Navin
authors.initials: N
authors.lastname: Pinto
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology/Stem Cell Transplantation, Comer Children's Hospital, University of Chicago, Chicago, Illinois.
authors.forename: Hillary M
authors.initials: HM
authors.lastname: Hecktman
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology/Stem Cell Transplantation, Comer Children's Hospital, University of Chicago, Chicago, Illinois.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Cohn
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology/Stem Cell Transplantation, Comer Children's Hospital, University of Chicago, Chicago, Illinois.
authors.forename: James L
authors.initials: JL
authors.lastname: LaBelle
mesh_terms: D064592:Autografts; D002675:Child, Preschool; D005260:Female; D006801:Humans; D009447:Neuroblastoma / Q000473:pathology / Q000628:therapy*; D012867:Skin / Q000473:pathology; D033581:Stem Cell Transplantation; D013831:Thiamine / Q000008:administration & dosage*; D014899:Wernicke Encephalopathy / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
chemical_list: D013831:Thiamine
keywords: Wernicke encephalopathy; neuroblastoma; total parenteral nutrition; vitamin B1