Wernicke Encephalopathy Associated with Crohn’s Disease

Poorly controlled Crohn’s disease is associated with several complications, including malabsorption of vitamins and minerals such as vitamin D, vitamin B12, and vitamin B1 (thiamine). Thiamine, among other vitamins, plays a crucial role in Adenosine Triphosphate formation as well as nerve propagati...

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Main Authors: Marco Vidor, Wirdasari Wirdasari, Virly Nanda Muzellina, Simon Salim
Format: Article
Language:English
Published: Interna Publishing 2025-07-01
Series:Acta Medica Indonesiana
Subjects:
Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2616
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author Marco Vidor
Wirdasari Wirdasari
Virly Nanda Muzellina
Simon Salim
author_facet Marco Vidor
Wirdasari Wirdasari
Virly Nanda Muzellina
Simon Salim
author_sort Marco Vidor
collection DOAJ
description Poorly controlled Crohn’s disease is associated with several complications, including malabsorption of vitamins and minerals such as vitamin D, vitamin B12, and vitamin B1 (thiamine). Thiamine, among other vitamins, plays a crucial role in Adenosine Triphosphate formation as well as nerve propagation. Thiamine deficiency initially manifests as wet or dry beriberi but may lead to the devastating Wernicke–Korsakoff syndrome. In this report, we present a case of full-blown Wernicke encephalopathy associated with uncontrolled Crohn’s disease. An 18-year-old young man was admitted with a chief complaint of hematemesis for 2 weeks before admission. He was previously diagnosed with Crohn’s disease in the past year, with constipation as the predominant symptom, and has been taking mesalazine 500 mg twice daily. Esophagogastroduodenoscopy and colonoscopy re-evaluation showed a worsening picture of Crohn’s disease pangastritis. The patient experienced swelling in both legs, the scrotum, and the upper extremities during hospital admission. On day 14 of hospitalization, the patient fell into a state of confusion with visual and auditory hallucinations, ophthalmoplegia, and ataxia. A Brain MRI showed a typical picture of Wernicke encephalopathy. Intravenous thiamine was administered, and the patient regained consciousness. His clinical symptoms improved every day until he was discharged. Uncontrolled Crohn’s disease may have several complications that clinicians need to be aware of, including thiamine deficiency. Wernicke encephalopathy shows a devastating clinical picture, but with thiamine therapy, it may resolve before further deterioration leads to irreversible Korsakoff syndrome.
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spelling doaj-art-4cd61a0ab13b4fe3a442eb4240b8bf872025-08-20T03:17:58ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322025-07-01572Wernicke Encephalopathy Associated with Crohn’s DiseaseMarco Vidor0Wirdasari Wirdasari1Virly Nanda Muzellina2Simon Salim3Faculty of Medicine University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, IndonesiaFaculty of Medicine University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, IndonesiaFaculty of Medicine University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, IndonesiaDivision of Cardiovascular, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia Poorly controlled Crohn’s disease is associated with several complications, including malabsorption of vitamins and minerals such as vitamin D, vitamin B12, and vitamin B1 (thiamine). Thiamine, among other vitamins, plays a crucial role in Adenosine Triphosphate formation as well as nerve propagation. Thiamine deficiency initially manifests as wet or dry beriberi but may lead to the devastating Wernicke–Korsakoff syndrome. In this report, we present a case of full-blown Wernicke encephalopathy associated with uncontrolled Crohn’s disease. An 18-year-old young man was admitted with a chief complaint of hematemesis for 2 weeks before admission. He was previously diagnosed with Crohn’s disease in the past year, with constipation as the predominant symptom, and has been taking mesalazine 500 mg twice daily. Esophagogastroduodenoscopy and colonoscopy re-evaluation showed a worsening picture of Crohn’s disease pangastritis. The patient experienced swelling in both legs, the scrotum, and the upper extremities during hospital admission. On day 14 of hospitalization, the patient fell into a state of confusion with visual and auditory hallucinations, ophthalmoplegia, and ataxia. A Brain MRI showed a typical picture of Wernicke encephalopathy. Intravenous thiamine was administered, and the patient regained consciousness. His clinical symptoms improved every day until he was discharged. Uncontrolled Crohn’s disease may have several complications that clinicians need to be aware of, including thiamine deficiency. Wernicke encephalopathy shows a devastating clinical picture, but with thiamine therapy, it may resolve before further deterioration leads to irreversible Korsakoff syndrome. http://www.actamedindones.org/index.php/ijim/article/view/2616Crohn’s diseasethiamine deficiencyWernicke encephalopathyKorsakoff syndrome
spellingShingle Marco Vidor
Wirdasari Wirdasari
Virly Nanda Muzellina
Simon Salim
Wernicke Encephalopathy Associated with Crohn’s Disease
Acta Medica Indonesiana
Crohn’s disease
thiamine deficiency
Wernicke encephalopathy
Korsakoff syndrome
title Wernicke Encephalopathy Associated with Crohn’s Disease
title_full Wernicke Encephalopathy Associated with Crohn’s Disease
title_fullStr Wernicke Encephalopathy Associated with Crohn’s Disease
title_full_unstemmed Wernicke Encephalopathy Associated with Crohn’s Disease
title_short Wernicke Encephalopathy Associated with Crohn’s Disease
title_sort wernicke encephalopathy associated with crohn s disease
topic Crohn’s disease
thiamine deficiency
Wernicke encephalopathy
Korsakoff syndrome
url http://www.actamedindones.org/index.php/ijim/article/view/2616
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AT simonsalim wernickeencephalopathyassociatedwithcrohnsdisease