TY - JOUR
T1 - Iatrogenic Wernicke encephalopathy in a patient with severe hyperemesis gravidarum
AU - Giugale, Lauren E.
AU - Young, Omar M.
AU - Streitman, David C.
N1 - Publisher Copyright:
© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/5/22
Y1 - 2015/5/22
N2 - BACKGROUND: Hyperemesis gravidarum complicates 0.5-2.0% of pregnancies and may lead to substantial nutritional deficiencies. Total parenteral nutrition can be used in severe cases in an attempt to avoid such deficiencies. Rarely, thiamine deficiency resulting in Wernicke encephalopathy occurs, with significant maternal morbidity. CASE: We present the case of a 30-year-old woman with hyperemesis gravidarum at 13 4/7 weeks of gestation treated with prolonged total parenteral nutrition that lacked thiamine supplementation, resulting in iatrogenic Wernicke encephalopathy. After high-dose intravenous thiamine repletion, she experienced slow resolution of her symptoms. CONCLUSION: Pregnancies complicated by hyperemesis gravidarum treated with total parenteral nutrition represent potential high-risk clinical scenarios for thiamine deficiency. Compositions of total parenteral nutrition are not standardized. Thus, physicians must confirm repletion of all essential components to avoid significant morbidity.
AB - BACKGROUND: Hyperemesis gravidarum complicates 0.5-2.0% of pregnancies and may lead to substantial nutritional deficiencies. Total parenteral nutrition can be used in severe cases in an attempt to avoid such deficiencies. Rarely, thiamine deficiency resulting in Wernicke encephalopathy occurs, with significant maternal morbidity. CASE: We present the case of a 30-year-old woman with hyperemesis gravidarum at 13 4/7 weeks of gestation treated with prolonged total parenteral nutrition that lacked thiamine supplementation, resulting in iatrogenic Wernicke encephalopathy. After high-dose intravenous thiamine repletion, she experienced slow resolution of her symptoms. CONCLUSION: Pregnancies complicated by hyperemesis gravidarum treated with total parenteral nutrition represent potential high-risk clinical scenarios for thiamine deficiency. Compositions of total parenteral nutrition are not standardized. Thus, physicians must confirm repletion of all essential components to avoid significant morbidity.
UR - http://www.scopus.com/inward/record.url?scp=84928140008&partnerID=8YFLogxK
U2 - 10.1097/AOG.0000000000000557
DO - 10.1097/AOG.0000000000000557
M3 - Article
C2 - 25774927
AN - SCOPUS:84928140008
SN - 0029-7844
VL - 125
SP - 1150
EP - 1152
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 5
ER -