Document Detail

Distinctive acid-base pattern in Wernicke's encephalopathy.
MedLine Citation:
PMID:  17145109     Owner:  NLM     Status:  MEDLINE    
Wernicke's encephalopathy may result in severe morbidity and possible mortality when unrecognized. We report a distinctive acid-base pattern that has not been associated with this syndrome. This is a case series of patients with Wernicke's encephalopathy who had an arterial blood gas measurement performed on initial presentation. Exclusion criteria were patients with an unclear diagnosis of Wernicke's encephalopathy and those for whom no arterial blood gas measurement was performed. Four patients with Wernicke's encephalopathy were included in the analysis. All 4 patients exhibited an anion-gap (primary) metabolic acidosis, accompanied by a primary respiratory alkalosis. Three of 4 patients exhibited a significant lactic acidosis. None of the patients had any competing diagnoses or dysfunction to account for this acid-base pattern. Patients with Wernicke's encephalopathy may exhibit a distinctive acid-base pattern consisting of a primary metabolic acidosis in conjunction with a primary respiratory alkalosis. Observation of this acid-base disturbance should prompt clinicians to consider thiamine deficiency disorders as a possible cause.
Michael W Donnino; Joseph Miller; A Joseph Garcia; Edward McKee; Mark Walsh
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-12-04
Journal Detail:
Title:  Annals of emergency medicine     Volume:  50     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-20     Completed Date:  2007-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  722-5     Citation Subset:  AIM; IM    
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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MeSH Terms
Acid-Base Imbalance / blood*,  diagnosis,  etiology*
Biological Markers / blood
Blood Gas Analysis
Emergency Medicine / methods
Middle Aged
Thiamine / therapeutic use
Treatment Outcome
Vitamin B Complex / therapeutic use
Wernicke Encephalopathy / blood*,  complications*,  diagnosis,  drug therapy
Reg. No./Substance:
0/Biological Markers; 12001-76-2/Vitamin B Complex; 59-43-8/Thiamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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