Wernicke encephalopathy and pellagra in an alcoholic and malnourished patient. (21st October 2015)

• Record Type: Journal Article
• Authors: Terada, Norihiko; Kinoshita, Kensuke; Taguchi, Shijima; Tokuda, Yasuharu
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-10-21
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2015-209412
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Deficiency of multiple vitamins can be identified in alcoholic and malnourished patients. We report a patient with Wernicke encephalopathy, a B1 deficiency and pellagra, a niacin deficiency. A 61-year-old Japanese man presented with generalised weakness. He had drunk alcohol heavily for more than a year without eating adequate meals. Physical examination showed disorientation, eye movement impairment, muscle wasting and a rash over the limbs. Multivitamin supplementations improved all the symptoms. Pellagra causes dementia, diarrhoea, or dermatitis, and can mimic non-specific erythaema in alcoholics. The differential diagnosis between pellagra and non-specific erythaema is important because of the treatability of pellagra by niacin supplementation.