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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| Format: | Article |
| Language: | English |
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Interna Publishing
2025-07-01
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| Series: | Acta Medica Indonesiana |
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| 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 |
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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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| format | Article |
| id | doaj-art-4cd61a0ab13b4fe3a442eb4240b8bf87 |
| institution | DOAJ |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| 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 |
| work_keys_str_mv | AT marcovidor wernickeencephalopathyassociatedwithcrohnsdisease AT wirdasariwirdasari wernickeencephalopathyassociatedwithcrohnsdisease AT virlynandamuzellina wernickeencephalopathyassociatedwithcrohnsdisease AT simonsalim wernickeencephalopathyassociatedwithcrohnsdisease |