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Can depressed cancer patients with a borderline thiamine concentration develop deficiency within a short time period?

Published online by Cambridge University Press:  23 January 2023

Nozomu Uchida Open the ORCID record for Nozomu Uchida [Opens in a new window] ,
Mayumi Ishida Open the ORCID record for Mayumi Ishida [Opens in a new window] ,
Akira Yoshioka ,
Izumi Sato ,
Hiroshi Ito ,
Nobuyuki Onizawa ,
Ryota Sato ,
Naoki Mizunuma  and
Hideki Onishi Open the ORCID record for Hideki Onishi [Opens in a new window]
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Akira Yoshioka
Affiliation:
Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, Japan
Izumi Sato
Affiliation:
Department of Clinical Epidemiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Hiroshi Ito
Affiliation:
Department of Internal Medicine, Ito Internal Medicine and Pediatric Clinic, Fukuoka, Japan
Nobuyuki Onizawa
Affiliation:
Department of General Medicine, Anzu Clinic, Saitama, Japan
Ryota Sato
Affiliation:
Department of Pharmacy, Maruki Memorial Medical and Social Welfare Center, Saitama, Japan
Naoki Mizunuma
Affiliation:
Tokyo Kagurazaka Law Firm, Tokyo, Japan
Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Hideki Onishi, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. Email: honishi@saitama-med.ac.jp
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Abstract

Background

Despite increasing reports of thiamine deficiency (TD) among cancer patients, there remain some patients with borderline thiamine concentrations (BTC). However, it is unclear whether such patients subsequently develop TD.

Methods

Here, we report cases of cancer patients progressing to TD within a short time period after presentation with BTC (24–28 ng/ml).

Results
Case 1

A 49-year-old female with lung cancer. During treatment for depression, the patient showed a decreased appetite, and a blood sample revealed BTC (25 ng/ml). Fourteen days later, she reported a continued loss of appetite, and despite the absence of the 3 classical signs of Wernicke encephalopathy (WE), additional testing showed a thiamine level of 23 ng/ml, leading to a diagnosis of TD.

Case 2

A 65-year-old female developed depression during chemotherapy for angiosarcoma. Her blood sample revealed BTC (25 ng/ml). Seven days later, despite the absence of the classical signs of WE, a further testing revealed a thiamine level of 20 ng/ml.

Case 3

A 41-year-old female developed depression during chemotherapy for ovarian cancer. No loss of appetite was observed, but a blood sample revealed BTC (25 ng/ml). Seven days later, despite the absence of the classical signs of WE or decreased appetite, further testing revealed a thiamine level of 19 ng/ml.

Significance of results

Depressed cancer patients with BTC may develop TD within a short time frame. To prevent TD, health-care professionals should maintain an awareness of its potential and the need for regular testing of thiamine level or prophylactic replacement therapy.

Keywords

Thiamine deficiencyWernicke encephalopathyBorderline levelDepressionCancer
Type
Case Report
Information
Palliative & Supportive Care , Volume 21 , Issue 4 , August 2023 , pp. 768 - 771
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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