Iatrogenic Wernicke encephalopathy in a patient with severe hyperemesis gravidarum

Lauren E. Giugale, Omar M. Young, David C. Streitman

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1150-1152
Number of pages3
JournalObstetrics and gynecology
Volume125
Issue number5
DOIs
StatePublished - May 22 2015

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