Thiamine deficiency : A case presentation and literature review
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This case examines the complicated hospital course of a patient ultimately diagnosed with thiamine deficiency. The presentation, diagnostic work up, and treatment of a 53-year-old male with a history of schizoaffective disorder, pituitary adenoma status post trans-sphenoidal adenectomy, GERD, hyperlipidemia, and glaucoma are evaluated. He had lived at a care facility for over 10 years, and he was brought to an outside hospital after members of the staff found him in bed, unresponsive. They also had concerns about a one-day history of inability to sit or stand up straight and gait abnormalities. An extensive work up with chest x-ray, EKG, urinalysis, routine CBC and CMP, blood and urine cultures, head CT, MRI of the brain and spine, lumbar puncture, EEG, and various miscellaneous labs ensued. Urinalysis and urine cultures revealed evidence of Enterococcus urinary tract infection. EEG revealed evidence of encephalopathy. The patient was also hyponatremic with thiamine and pyridoxine deficiency. Thiamine deficiency was diagnosed after a dramatic improvement in gait and mentation after administration of thiamine.
A Easter, N Katta. Thiamine Deficiency: A Case Presentation and Literature Review. Journal of Academic Hospital Medicine 2014, Volume 6, Issue 4.