Journal article
Fetal demise and Wernicke-Korsakoff syndrome in a patient with hyperemesis gravidarum: a case report
Journal of medical case reports, Vol.17(1), 32
02 Feb 2023
PMID: 36726136
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Wernicke-Korsakoff syndrome is a neuropsychiatric disorder caused by thiamine deficiency composed of two related disorders accounting for an acute presentation and chronic progression. Hyperemesis gravidarum presents a significant risk factor for Wernicke-Korsakoff syndrome as symptoms may rapidly progress in the setting of pregnancy. We present the first-reported case of hyperemesis-gravidarum-associated Wernicke encephalopathy in a patient in the first half of pregnancy in which a missed diagnosis led to septic shock, fetal demise, and eventual profound Korsakoff syndrome.
We present the case of a 33-year-old primigravid African American woman at 15 weeks gestational age who initially presented at a community emergency department with nausea and vomiting that ultimately progressed to severe hyperemesis-gravidarum-associated Wernicke-Korsakoff syndrome, fetal demise, and septic shock. The patient received a total of 6 weeks of high-dose parenteral thiamine. Magnetic resonance imaging of the head and formal neuropsychological assessment following treatment plateau confirmed the diagnosis of Wernicke-Korsakoff syndrome.
The multisystem complications seen in severe thiamine deficiency can delay timely administration of high-dose thiamine, particularly in pregnancy, in which the classic triad of Wernicke-Korsakoff syndrome may not raise clinical suspicion due to rapid progression of neurological sequelae in this population. We advise a low threshold for parenteral thiamine repletion in pregnant women with persistent vomiting as hyperemesis gravidarum-induced severe thiamine deficiency can result in Wernicke-Korsakoff syndrome, sepsis, and fetal demise.
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Details
- Title
- Fetal demise and Wernicke-Korsakoff syndrome in a patient with hyperemesis gravidarum: a case report
- Creators
- Alisa Olmsted - Thomas Jefferson University HospitalAndrea DeSimone - Bayhealth FoundationJahaira Lopez-Pastrana - Thomas Jefferson University HospitalMadeleine Becker - Thomas Jefferson University Hospital
- Publication Details
- Journal of medical case reports, Vol.17(1), 32
- Publisher
- BM
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychiatry
- Web of Science ID
- WOS:000924089300001
- Scopus ID
- 2-s2.0-85147234996
- Other Identifier
- 991022054323104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Medicine, General & Internal