简介:维生素B1缺乏会导致意识障碍的风险很大,表现从厌食和疲劳到严重的神经和心血管疾病。韦尼克的脑病,由维生素B1缺乏引起的神经系统疾病,表现为眼肌麻痹的三联征,改变了精神状态,和小脑共济失调.然而,这些症状并不总是存在,使诊断复杂化。此外,亚临床维生素B1缺乏可在出现严重并发症之前未被发现.研究表明,未确诊病例的发生率很高,强调早期发现和干预的必要性。病例介绍:我们介绍了一个65岁男性的病例,其中偶然发现了高乳酸血症,导致维生素B1缺乏的诊断。病人,表现为眩晕和呕吐,在他妻子3年前去世后,他一直在吃从便利店买的盒装午餐。眩晕随着休息逐渐好转,但是高乳酸血症的持续存在促使了进一步的调查,显示低维生素B1水平和高丙酮酸水平。饮食调整和补充剂治疗显着改善了他的症状。讨论:在这种情况下,在一名眩晕患者中发现了高乳酸血症,提示无症状的维生素B1缺乏。乳酸升高通常与败血症等疾病有关,但也可能源于被忽视的因素,例如由于食用油炸食品等不良饮食习惯而导致的维生素B1水平低。结论:该病例强调了在原因不明的高乳酸血症患者中考虑维生素B1缺乏的重要性,即使是在高收入国家。早期发现可以防止进展为与Wernicke脑病相关的严重并发症。主动测量高危人群的乳酸水平可能有助于早期诊断和干预。最终改善患者预后。
Introduction: Vitamin B1 deficiency poses a significant risk of impaired consciousness, with manifestations ranging from anorexia and fatigue to severe neurological and cardiovascular disturbances. Wernicke\'s encephalopathy, a neurological disorder stemming from vitamin B1 deficiency, presents as the triad of ophthalmoplegia, altered mental state, and cerebellar ataxia. However, these symptoms are not consistently present, complicating the diagnosis. In addition, subclinical vitamin B1 deficiency can progress unnoticed until severe complications arise. Studies indicate a high rate of undiagnosed cases, emphasizing the need for early detection and intervention.
Case presentation: We present the
case of a 65-year-old man in whom hyperlactatemia was incidentally detected, leading to the diagnosis of vitamin B1 deficiency. The patient, presenting with vertigo and vomiting, had been eating boxed lunches bought from convenience stores following the death of his wife 3 years earlier. Vertigo gradually improved with rest, but the persistence of hyperlactatemia prompted further investigation, revealing low vitamin B1 levels and high pyruvate levels. Treatment with dietary adjustments and supplements significantly improved his symptoms. Discussion: In this
case, hyperlactatemia was found in a vertigo patient, revealing asymptomatic vitamin B1 deficiency. Elevated lactate is often linked with conditions like sepsis but can also stem from overlooked factors such as low vitamin B1 levels due to poor diet habits like consuming fried foods. Conclusion: This
case highlights the importance of considering vitamin B1 deficiency in patients with unexplained hyperlactatemia, even in high-income countries. Early detection can prevent progression to the severe complications associated with Wernicke\'s encephalopathy. Proactive measurement of lactate levels in at-risk populations may facilitate early diagnosis and intervention, ultimately improving patient outcomes.