Thiamine deficiency as a differential diagnosis for severe fatigue in terminally ill cancer patients.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-03 DOI:10.1017/S1478951524001536

Hideki Onishi, Hiroko Sato, Nozomu Uchida, Akira Yoshioka, Izumi Sato, Nobuyuki Onizawa, Hiroshi Ito, Mayumi Ishida

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Abstract

Objectives: Patients with advanced cancer present various symptoms as their disease progresses. Among these, fatigue is a frequent symptom in patients with advanced cancer and is associated with decreased quality of life (QOL). However, there are few reports regarding its association with thiamine deficiency (TD).

Methods: We report a case in which we found TD in a patient with advanced lung cancer who presented with weight loss, significant fatigue, and appeared to have a worsening general condition, for whom symptoms were dramatically improved within a short period of time by intravenous administration of thiamine.

Results: The patient was a 76-year-old woman who had been diagnosed with lung cancer and liver metastases 6 months earlier. Due to interstitial pneumonia, she was not a candidate for chemotherapy and so palliative care was started. At 8 months after initial diagnosis, the patient complained of fatigue during a medical examination, so a blood sample was taken. A week later, she visited the hospital with a cane. She felt extremely fatigued and was unable to stand, but results from the previous blood test revealed that a TD. The fatigue disappeared 15 minutes after intravenous administration of thiamine and she was able to return home without the cane.

Significance of results: Fatigue is a frequent symptom in advanced cancer patients, and TD may be the underlying cause. Inclusion of TD in the differential diagnosis may contribute to improving patient QOL.

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将硫胺素缺乏症作为癌症晚期患者严重疲劳的鉴别诊断。

目的：晚期癌症患者随着病情的发展会出现各种症状。其中，疲劳是晚期癌症患者经常出现的症状，并与生活质量（QOL）下降有关。然而，有关疲劳与硫胺素缺乏症（TD）相关的报道却很少：我们报告了一例发现硫胺素缺乏症的晚期肺癌患者的病例，该患者出现体重减轻、明显乏力，全身状况似乎也在恶化，通过静脉注射硫胺素，其症状在短时间内得到了显著改善：患者是一名 76 岁的女性，6 个月前被诊断出患有肺癌和肝转移。由于患有间质性肺炎，她不适合接受化疗，因此开始接受姑息治疗。初诊 8 个月后，患者在体检时抱怨疲倦，因此被采集了血样。一周后，她拄着拐杖到医院就诊。她感到极度疲劳，无法站立，但之前的血液检测结果显示她患有 TD。静脉注射硫胺素 15 分钟后，她的疲劳感消失了，可以不用拐杖回家：结果的意义：疲劳是晚期癌症患者的常见症状，TD 可能是其根本原因。将 TD 纳入鉴别诊断有助于改善患者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.