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Wernicke encephalopathy in a caregiver: A serious physical issue resulting from stress in a family member caring for an advanced cancer patient

Published online by Cambridge University Press:  23 November 2021

Mayumi Ishida Open the ORCID record for Mayumi Ishida [Opens in a new window] ,
Nozomu Uchida Open the ORCID record for Nozomu Uchida [Opens in a new window] ,
Akira Yoshioka ,
Izumi Sato ,
Tetsuya Hamaguchi ,
Yosuke Horita ,
Yoshiaki Mihara  and
Hideki Onishi Open the ORCID record for Hideki Onishi [Opens in a new window]
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
Akira Yoshioka
Affiliation:
Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, Japan
Izumi Sato
Affiliation:
Department of Clinical Epidemiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Tetsuya Hamaguchi
Affiliation:
Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Yosuke Horita
Affiliation:
Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Yoshiaki Mihara
Affiliation:
Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Hideki Onishi, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. E-mail: [email protected]
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Abstract

Objective

It is well known that the burden on the families of cancer patient extends across many aspects, but there have been no reports of family members developing delirium due to the burden of caring for a cancer patient.

Methods

We reported a caregiver who developed Wernicke encephalopathy (WE) while caring for a family member with advanced cancer.

Results

The subject was a 71-year-old woman who had been caring for her husband, diagnosed with gastric cancer and liver metastases, for 5 months. She visited the “caregivers’ clinic” after referral by an oncologist who was worried about a deterioration in her mental condition that had appeared several weeks previously. The woman had a history of diabetes mellitus. Some giddiness was observed and, based on her inability to answer questions, her level of consciousness was checked and some disorientation was observed. She was diagnosed with delirium. A blood sample was collected to investigate the cause of the delirium, but the test data showed no hypoglycemia. Her appetite had declined since her husband was diagnosed with cancer. Thiamine deficiency was suspected as thiamine stores in the body are depleted within about 18 days and her loss of appetite had continued for 5 months. On intravenous injection of 100 mg of thiamine, her consciousness level was returned to normal in 1 h. A diagnosis of WE was supported by the patient's abnormally low serum thiamine level.

Significance of the results

The family members of cancer patients may develop a loss of appetite due to the burden of caring, resulting in WE. When providing care for signs of distress in family members, it is necessary to pay attention not only to the psychological aspects but also to their level of consciousness and physical aspects, particularly the possibility of serious illness resulting from reduced nutritional status.

Keywords

CaregiverDeliriumDiabetes mellitusThiamine deficiencyWernicke encephalopathy
Type
Case Report
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 600 - 602
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

REFERENCES

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Publishing.Google Scholar
Bhardwaj, A, Watanabe, M and Shah, JR (2008) A 46-yr-old woman with ataxia and blurred vision 3 months after bariatric surgery. The American Journal of Gastroenterology 103(6), 1575–1577.CrossRefGoogle ScholarPubMed
Braun, M, Mikulincer, M, Rydall, A, et al. (2007) Hidden morbidity in cancer: Spouse caregivers. Journal of Clinical Oncology 25(30), 4829–4834.CrossRefGoogle ScholarPubMed
Hudson, PL, Thomas, K, Trauer, T, et al. (2011) Psychological and social profile of family caregivers on commencement of palliative care. Journal of Pain and Symptom Management 41(3), 522–534.CrossRefGoogle ScholarPubMed
Johansen, S, Cvancarova, M and Ruland, C (2018) The effect of cancer patients’ and their family caregivers’ physical and emotional symptoms on caregiver burden. Cancer Nursing 41(2), 91–99.CrossRefGoogle ScholarPubMed
Lederberg, M (1998) The family of the cancer patient. In Holland, J (ed.), Psychooncology. New York: Oxford University Press, pp. 981–993.Google Scholar
Matthews, DR, Paldánius, PM, Proot, P, et al. (2019) Glycaemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY): A 5-year, multicentre, randomised, double-blind trial. Lancet 394(10208), 1519–1529.CrossRefGoogle ScholarPubMed
Onishi, H, Ishida, M, Uchida, N, et al. (2019) Thiamine deficiency observed in a cancer patient's caregiver. Palliative & Supportive Care 17(5), 611–613.CrossRefGoogle 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.CrossRefGoogle ScholarPubMed
Sechi, G, Sechi, E, Fois, C, et al. (2016) Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutrition reviews 74(5), 281–300.CrossRefGoogle ScholarPubMed