Wernicke's Encephalopathy after Gastrectomy and Adjuvant Chemotherapy Using S-1 for Gastric cancer :Report of a Case
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概要
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Wernicke's encephalopathy is a disease usually related to chronic alcoholism. We reported a case of Wernicke'sencephalopathy after distal gastrectomy and chemotherapy using S-1 despite of no history of alcoholism.A 58-year-old woman underwent distal gastrectomy for gastric carcinoma in February, 2005. Shereceived adjuvant chemotherapy using S-1, since histological examination of the removal specimens showedregional lymph nodes metastasis. After this therapy, she rapidly developed diplopia, ataxia and disturbanceof consciousness. Although brain CT and the routine laboratory data showed no abnormal changes, brainMRI showed a symmetrical high-intensity area in the third ventricle and periaqueductal regions;this wascharacteristic of Wernicke's encephalopathy. She was immediately treated with thiamine, and recoveredconsciousness within a few hours. S-1 based on 5-fluorouracil( 5-FU) which reduced the thiamine levels inthe patient, may have worsened the thiamine deficiency caused by distal gastorectomy. Therefore, cliniciansshould pay attention to suspicious symptoms of thiamine deficiency in patients who have undergone gastrectomy,particularly those who receive adjuvant chemotherapy with S-1 or 5-FU.
- 2009-07-25
著者
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Tetsuro Nakamura
Department Of Surgery Koshigaya Hospital Dokkyo University School Of Medicine
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Tsuyotoshi Izumisato
Department Of Surgery Koshigaya Hospital Dokkyo University School Of Medicine
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Izumisato Tsuyotoshi
Department Of Surgery Dokkyo Medical University Koshigaya Hospital
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Masahiko Yamaguchi
Department Of Surgery Koshigaya Hospital Dokkyo University School Of Medicine
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Takashi Okuyama
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
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Takashi Okuyama
Department Of Surgery Koshigaya Hospital Dokkyo University School Of Medicine
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Okuyama Takashi
Department Of Biosphere Resources Sciences Graduate School Of Bio-agricultural Sciences Nagoya Unive
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Nakamura Tetsuro
Department Of Colorectal Surgery Cleveland Clinic Florida
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Yamaguchi Masahiko
Department Of Chemistry Faculty Of Science Tohoku University
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Yamaguchi Masahiko
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
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Okuyama Takashi
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
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Nakamura Tetsuro
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
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Nakamura Tetsuro
Department of Applied Physics and Physico-Informatics, Faculty of Science and Technology, Keio University, Yokohama 223-8522, Japan
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Izumisato Tsuyotoshi
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
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Yamaguchi Masahiko
Department of Applied Chemistry, Kyushu Institute of Technology
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