Refeeding Syndrome and Non-Alcoholic Wernicke’s Encephalopathy in a Middle-aged Male Initially Presenting with Gallstone Pancreatitis: A Clinical Challenge

Butt, Ifrah; Ulloa, Nicolas A.; Surapaneni, Balarama K; Kasmin, Franklin

doi:10.7759/cureus.5156

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…Keywords: nutritional pancreatic necrosis, pancreatogenic encephalopathy, risk factors for pancreatogenic encephalopathy Панкреатогенная энцефалопатия (ПЭП) -часто встречающееся осложнение (9-35 %) панкреонекроза (ПН), которое может значительно повышать риск летального исхода (до 70 %) [1,2,3]. Некоторые авторы определяют ПЭП как наличие делириозоподобной неврологической симптоматики или нарушения сознания (менее 15 баллов по шкале ком Glasgow) у пациентов с панкреонекрозом [1,4,5].…”

Section: Methodsunclassified

Impact of Demographic Variables on the Risk of Pancreatogenic Encephalopathy in Patients With Nutritional Pancreatonecrosis

Бебуришвили

Mikhin

Burchuladze

et al. 2022

Journal of Volgograd State Medical University

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Resume. Aim. Study of the dependence of the degree of risk of developing pancreatogenic encephalopathy (PEP) on demographic variables in patients with nutritional pancreatic necrosis. Materials and methods. A single-center prospective cohort non-randomized study was conducted on the basis of the Faculty Surgery Clinic of the Volgograd State Medical University in the period from 2010 to 2020. To determine the significance of the influence of a patient-dependent factor on the risk of developing PEP, ROC analysis was used. Logistic regression analysis was used to determine the degree of risk of developing PEP against the background of a combination of several covariates. Results. The study included 429 patients with pancreatic necrosis of alimentary origin. A comparative analysis of the incidence of PEP was carried out depending on gender and age, the trigger of the disease (alcohol-associated versus non-alcoholic pancreatic necrosis) and comorbid background. It has been proven that significant factors that increase the risk of developing PEP are age over 60 years (p = 0,04), alcohol-associated pancreatic necrosis (p < 0,001) and cardiovascular pathology - ischemic heart disease (p < 0,001). A statistically significant regression model of the effect of cardiovascular pathology on the incidence of PEP has been developed, which makes it possible to calculate the risk of this complication in a particular patient. Conclusions. Significant demographic variables that increase the risk of PEP include age over 60 years, alcoholic pancreatitis, and the presence of coronary artery disease in a patient. The developed logistic model makes it possible to calculate the personalized risk of PEP during hospitalization of a patient with nutritional pancreatic necrosis.

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Section: Methodsunclassified

Impact of Demographic Variables on the Risk of Pancreatogenic Encephalopathy in Patients With Nutritional Pancreatonecrosis

Бебуришвили

Mikhin

Burchuladze

et al. 2022

Journal of Volgograd State Medical University

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Non-alcoholic Wernicke’s encephalopathy in a kidney transplant recipient

Kantariya

Vetchinnikova

Vatazin

et al. 2021

RJTAO

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Background. Non-alcoholic Wernicke’s encephalopathy occurs in various somatic conditions with thiamine deficiency, excessive excretion of thiamine, or impaired thiamine metabolism. Very few cases of this pathology have been described in chronic kidney disease (CKD). We present a unique case of non-alcoholic Wernicke’s encephalopathy in a patient with a kidney transplant is presented.Past medical history. The patient underwent kidney transplantation in 2008. Outpatient follow-up by a nephrologist was irregular. Renal graft function remained relatively stable: blood creatinine 200–240 μmol/L, estimated glomerular filtration rate 40–30 mL/min, tacrolimus plasma concentrations tended to increase (5.7–7.6–8.4–10.4 ng/mL); repeated graft biopsy (in 2015 and in 2017) determined the chronic toxicity of calcineurin inhibitors. The patient’s condition worsened in late January 2020: body temperature increased to 38°C, nausea, vomiting, loose, watery stools for up to 5 times per day, 8 kg weight loss, decreased diuresis. A few days later, double vision, shaky gait and then immobility appeared. Biochemical examination results: potassium 3.8 mmol/L, sodium 139 mmol/L, alpha-amylase 159 units/L (norm 0–100 units/L), creatinine 242 mmol/L, urea 13.2 mmol/L; ultrasound signs of pancreatitis. Magnetic resonance imaging (MRI) of the brain: bilateral diffuse lesions of the midbrain, thalamus, and cerebellum. Based on the clinical picture and on brain MRI results, Wernicke’s encephalopathy was diagnosed. Parenteral administration of thiamine had a good effect.Conclusion. Possible mechanisms of the development of Wernicke’s encephalopathy in a patient were discussed. Vigilance is required regarding this disease when metabolic disorders occur in patients with CKD.

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Prediction and diagnosis of pancreatogenic encephalopathy in patients with destructive pancreatitis

Бебуришвили¹,

Burchuladze²,

Mikhin³

et al. 2022

Khir. Z. im. N.I. Pirogova

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Refeeding Syndrome and Non-Alcoholic Wernicke’s Encephalopathy in a Middle-aged Male Initially Presenting with Gallstone Pancreatitis: A Clinical Challenge

Cited by 4 publications

References 8 publications

Impact of Demographic Variables on the Risk of Pancreatogenic Encephalopathy in Patients With Nutritional Pancreatonecrosis

Impact of Demographic Variables on the Risk of Pancreatogenic Encephalopathy in Patients With Nutritional Pancreatonecrosis

Non-alcoholic Wernicke’s encephalopathy in a kidney transplant recipient

Prediction and diagnosis of pancreatogenic encephalopathy in patients with destructive pancreatitis

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