A Case of Acute Renal Failure with Wernicke's Encephalopathy and Beriberi due to Severe Hyperemesis Gravidarum.
- Author:
Hyun Jung SEOK
1
;
Choi JUNG
;
Jung Wook KIM
;
Soon Bae KIM
;
Su Kil PARK
;
Jung Sik PARK
;
Sang Koo LEE
Author Information
1. Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. sklee@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Wernicke's encephalopathy;
Acute renal failure;
Hyperemesis
- MeSH:
Acute Kidney Injury*;
Adult;
Beriberi*;
Creatinine;
Dehydration;
Dilatation;
Echocardiography;
Female;
Humans;
Hyperemesis Gravidarum*;
Malnutrition;
Nausea;
Peripheral Nervous System Diseases;
Pregnancy;
Quadriplegia;
Tachycardia;
Thiamine;
Thiamine Deficiency;
Urea;
Vomiting;
Wernicke Encephalopathy*
- From:Korean Journal of Nephrology
2007;26(2):274-278
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Severe hyperemesis gravidarum (HG) is a rare but potentially devastating complication of pregnancy. It can cause dehydration, electrolyte imbalance, malnutrition (especially, thiamine deficiency), and compromised renal function. We report a case of acute renal failure (ARF) with Wernicke's encephalopathy and beriberi due to severe HG. A 35-year-old woman at 16 weeks of gestation presented with confused mentality, quadriparesis, nystagmus, peripheral neuropathy, and tachycardia after prolonged nausea and vomiting. Her initial serum creatinine and blood urea were 2.6 mg/dL and 100 mg/dL, respectively. FLAIR image of the initial MR examination demonstrated bilateral symmetric high signal intensities in the medial and dorsal thalami. Echocardiography showed left ventricular dilatation and dysfunction. We thought that ARF, Wernicke's encephalopathy and beriberi were resulted from dehydration and thiamine deficiency due to HG. She was managed with intravenous fluid and 100-200 mg of parenteral thiamine. ARF was improved within one week and echocardiographic findings were normalized within 1 month. MR examination at the 21st week of pregnancy showed a decreased size of the lesion. After 4 months, her neuroloic status was recovered.
