Zhang Y, Wang L, Jiang J, Chen WY. Non-alcoholic Wernicke encephalopathy in an esophageal cancer patient receiving radiotherapy: A case report. World J Clin Cases 2022; 10(17): 5810-5815 [PMID: 35979132 DOI: 10.12998/wjcc.v10.i17.5810]
Corresponding Author of This Article
Lei Wang, Doctor, Chief Doctor, Department of General Practice, The Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing 314000, Zhejiang Province, China. jxdyyywlyx@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2022; 10(17): 5810-5815 Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5810
Non-alcoholic Wernicke encephalopathy in an esophageal cancer patient receiving radiotherapy: A case report
Ye Zhang, Lei Wang, Jin Jiang, Wen-Yu Chen
Ye Zhang, Lei Wang, Department of General Practice, The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Jin Jiang, Department of Oncology, The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Wen-Yu Chen, Department of Respiration, The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Zhang Y and Jiang J were the patient’s doctors, reviewed the literature, and contributed to manuscript drafting; Wang L reviewed the literature and contributed to manuscript drafting; Chen WY analyzed and interpreted the imaging findings; Zhang Y and Wang L were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported bythe Scientific Technology Plan Program for Healthcare in Zhejiang Province, No. 2021KY1100; and the Key Discipline of Jiaxing General Practice Medicine Construction Project, No. 2019-fc-03.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Dr. Zhang reports grants from Scientific Technology Plan Program for Healthcare in Zhejiang Province during the conduct of the study.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Wang, Doctor, Chief Doctor, Department of General Practice, The Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing 314000, Zhejiang Province, China. jxdyyywlyx@163.com
Received: December 1, 2021 Peer-review started: December 1, 2021 First decision: January 12, 2022 Revised: January 13, 2022 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: June 16, 2022 Processing time: 190 Days and 6.5 Hours
Abstract
BACKGROUND
Wernicke encephalopathy is a rare but potentially fatal adverse event caused by thiamine deficiency. Reports of non-alcoholic Wernicke encephalopathy due to malignancy are scarce in the literature, with those reported mainly being on haematological cancer, followed by gastrointestinal cancer. As a result, there is considerable under-recognition and delay in the diagnosis and treatment of Wernicke encephalopathy in oncology departments. To our knowledge, there has been no report of Wernicke encephalopathy in a patient with esophageal cancer while receiving radiotherapy.
CASE SUMMARY
A 64-year-old man presented to the oncology outpatient clinic with a history of dysphagia for 2 mo, and was diagnosed with locally advanced esophageal squamous cell carcinoma (stage IIIB). Radiotherapy was initiated to alleviate dysphagia due to malignant esophageal stenosis; however, the patient exhibited consciousness disturbances starting on day 10 of radiotherapy. Brain magnetic resonance imaging indicated the development of Wernicke encephalopathy. Subsequent treatment with thiamine led to rapid improvement in the patient’s neurological symptoms.
CONCLUSION
Wernicke encephalopathy may develop in non-alcoholic patients undergoing radiotherapy for esophageal cancer. Early diagnosis and sufficient thiamine supplementation during radiotherapy are essential.
Core Tip: Wernicke encephalopathy is a neuropsychiatric disorder resulting from thiamine deficiency. It is frequently associated with alcoholism and is challenging to diagnose in non-alcoholic patients. Only scarce reports of Wernicke encephalopathy accompanying cancer have been reported, mainly in haematological malignancies followed by gastrointestinal malignancies. There have been no reports about Wernicke encephalopathy accompanying esophageal cancer. Here we report the first case of Wernicke encephalopathy in an esophageal cancer patient receiving radiotherapy. It is presented to emphasize that early nutritional evaluation and diagnosis are important. Prompt thiamine supplementation is the key to preventing permanent neurological damage.
