Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T09:06:01.700Z Has data issue: false hasContentIssue false
  • English
  • Français

Thiamine deficiency observed in a cancer patient's caregiver

Published online by Cambridge University Press:  30 January 2019

Hideki Onishi ,
Mayumi Ishida ,
Nozomu Uchida ,
Takao Takahashi ,
Daisuke Furuya ,
Yasuhiro Ebihara ,
Izumi Sato  and
Tatsuo Akechi
Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Takao Takahashi
Affiliation:
Department of Supportive Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Daisuke Furuya
Affiliation:
Department of General Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Yasuhiro Ebihara
Affiliation:
Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Izumi Sato
Affiliation:
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Tatsuo Akechi
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
*
Address for correspondence: Hideki Onishi, MD, PhD, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. E-mail: honishi@saitama-med.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer; however, TD has not been recognized in the family caregivers of cancer patients to date.

Method

From a series of cancer patient caregivers, we reported an aged family caregiver who developed TD while caring for the cancer patient.

Result

The caregiver was a 90-year-old male. He had been accompanying his wife, who was diagnosed with colon cancer 4 years previously, on hospital visits as the primary caregiver, but because of psychological issues, he was recommended to visit the psycho-oncology department's “caregiver's clinic” for a consultation. Detailed examination revealed that his appetite had been only about 50% of usual from about one year before, and he had lost 12 kg in weight in one year. The diagnosis of TD was supported by his abnormally low serum thiamine level.

Significance of the results

This report demonstrates that there is a possibility that care providers could develop TD from the burdens associated with caregiving. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of care providers to prevent complications resulting from TD.

Keywords

Thiamine deficiencyCancerFamilyCaregiverWernicke encephalopathy
Type
Case Report
Information
Palliative & Supportive Care , Volume 17 , Issue 5 , October 2019 , pp. 611 - 613
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th ed. Washington DC: American Psychiatric Publishing.Google Scholar
Carter, PA (2002) Caregivers' descriptions of sleep changes and depressive symptoms. Oncology Nursing Forum 29(9), 1277–1283.Google Scholar
Isenberg-Grzeda, E, Kutner, HE, and Nicolson, SE (2012) Wernicke-Korsakoff-syndrome: Under-recognized and under-treated. Psychosomatics 53(6), 507–516.Google Scholar
Isenberg-Grzeda, E, Rahane, S, DeRosa, AP, Ellis, J, and Nicolson, SE (2016) Wernicke-Korsakoff syndrome in patients with cancer: A systematic review. Lancet Oncology 17(4), e142–e148.Google Scholar
Lederberg, M (1998) The family of the cancer patient. In Psychooncology. Holland, J (ed.), pp. 981–993. Oxford University Press.Google Scholar
MacLean, LD, Rhode, BM, and Shizgal, HM (1983) Nutrition following gastric operations for morbid obesity. Annals of Surgery 198(3), 347–355.Google Scholar
Nichols, HK and Basu, TK (1994) Thiamin status of the elderly: Dietary intake and thiamin pyrophosphate response. Journal of the American College of Nutrition 13(1), 57–61.Google Scholar
Onishi, H, Ishida, M, Kagamu, H, Murayama, Y, Kobayashi, K, Sato, I, Uchida, N, and Akechi, T (2018a) Wernicke encephalopathy in a lung cancer patient during treatment with nivolumab. Palliative & Supportive Care 3, 1–3.Google Scholar
Onishi, H, Ishida, M, Takahashi, T, Taji, Y, Ikebuchi, K, Furuya, D, Uchida, N, and Akechi, T (2018b) Wernicke encephalopathy without delirium that appeared as agitation in a patient with lung cancer. Palliative & Supportive Care 1–3.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, Takahashi, T, Taji, Y, Ikebuchi, K, Furuya, D, and Akechi, T (2017) Subclinical thiamine deficiency in patients with abdominal cancer. Palliative & Supportive Care 16(4), 497–499.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, Takahashi, T, Taji, Y, Ikebuchi, K, Furuya, D, and Akechi, T (2018c) Wernicke encephalopathy without delirium in patients with cancer. Palliative & Supportive Care 16(1), 118–121.Google Scholar
Onishi, H, Kawanishi, C, Onose, M, Yamada, T, Saito, H, Yoshida, A, and Noda, K (2004) Successful treatment of Wernicke encephalopathy in terminally ill cancer patients: report of 3 cases and review of the literature. Support Care Cancer 12(8), 604–608.Google Scholar
Onishi, H, Sugimasa, Y, Kawanishi, C, and Onose, M (2005) Wernicke encephalopathy presented in the form of postoperative delirium in a patient with hepatocellular carcinoma and liver cirrhosis: a case report and review of the literature. Palliative & Support Care 3(4), 337–340.Google Scholar
Patrick, C, Padgett, DK, Schlesinger, HJ, Cohen, J, and Burns, BJ (1992) Serious physical illness as a stressor: Effects on family use of medical services. General Hospital Psychiatry 14(4), 219–227.Google Scholar
Sechi, G, Sechi, E, Fois, C, and Kumar, N (2016) Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutritional Reviews 74(5), 281–300.Google Scholar
Sechi, G and Serra, A (2007) Wernicke's encephalopathy: New clinical settings and recent advances in diagnosis and management. Lancet Neurology 6(5), 442–455.Google Scholar
Shaw, WS, Patterson, TL, Semple, SJ, Ho, S, Irwin, MR, Hauger, RL, and Grant, I (1997) Longitudinal analysis of multiple indicators of health decline among spousal caregivers. Annals of Behavioral Medicine 19(2), 101–109.Google Scholar
van Zaanen, HC and van der Lelie, J (1992) Thiamine deficiency in hematologic malignant tumors. Cancer 69(7), 1710–1713.Google Scholar
Victor, M, Adams, RD, and Collins, GH (1971) The Wernicke-Korsakoff syndrome. A clinical and pathological study of 245 patients, 82 with post-mortem examinations. Contemporary Neurology Services 7, 1–206.Google Scholar
Yae, S, Okuno, S, Onishi, H, and Kawanishi, C (2005) Development of Wernicke encephalopathy in a terminally ill cancer patient consuming an adequate diet: a case report and review of the literature. Palliative & Support Care 3(4), 333–335.Google Scholar