Wernicke encephalopathy and pellagra in an alcoholic and malnourished patient.
Deficiency of multiple vitamins can be identified in alcoholic and malnourished patients. We report a patient with Wernicke encephalopathy, a B1 deficiency and pellagra, a niacin deficiency. A 61-year-old Japanese man presented with generalised weakness. He had drunk alcohol heavily for more than a year without eating adequate meals. Physical examination showed disorientation, eye movement impairment, muscle wasting and a rash over the limbs. Multivitamin supplementations improved all the symptoms. Pellagra causes dementia, diarrhoea, or dermatitis, and can mimic non-specific erythaema in alcoholics. The differential diagnosis between pellagra and non-specific erythaema is important because of the treatability of pellagra by niacin supplementation.
Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Norihiko
N
Terada
Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Kensuke
K
Kinoshita
Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
Shijima
S
Taguchi
Department of General Internal Medicine, Tsukuba University, Mito, Ibaraki, Japan.
Yasuharu
Y
Tokuda
D000437:Alcoholism / Q000150:complications*; D003221:Confusion / Q000209:etiology; D003704:Dementia / Q000209:etiology; D003872:Dermatitis / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage; D010383:Pellagra / Q000150:complications / Q000175:diagnosis*; D013831:Thiamine / Q000008:administration & dosage; D014803:Vitamin B Complex / Q000008:administration & dosage; D014899:Wernicke Encephalopathy / Q000150:complications / Q000175:diagnosis*
D014803:Vitamin B Complex; D009525:Niacin; D013831:Thiamine