Wernicke’s Encephalopathy in hyperthyroidism and thyrotoxicosis: A systematic review

Thyroid Science Pub Date : 2025-03-07 DOI:10.1016/j.thscie.2025.100023

Erik Oudman

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Abstract

Background

Hyperthyroidism and thyrotoxicosis increase metabolic demands for vitamin B1 (thiamine), putting patients at risk for Wernicke’s Encephalopathy (WE), caused by severe thiamine deficiency. This review explores WE symptoms in hyperthyroidism and thyrotoxicosis.

Summary

A systematic review of case reports was conducted using PubMed, Embase, and Scopus with relevant keywords. Sixteen cases of WE associated with hyperthyroidism or thyrotoxicosis were identified. Common factors included weight loss (16/16 cases), vomiting (12/16 cases), and conditions like hyperemesis gravidarum (11/16 cases). The full WE triad appeared in 11 cases, with MRI showing classic thalamic hyperintensities in all tested cases (12/12). Recovery was incomplete in 7 cases, with 3 progressing to chronic Korsakoff’s syndrome. Thiamine treatment varied significantly.

Conclusions

Hyperthyroidism and thyrotoxicosis increase the risk of thiamine deficiency, particularly with weight loss or vomiting. Proactive monitoring and prophylactic thiamine treatment are essential in these patients. As symptoms of WE become increasingly prominent over time and lead to adverse outcome, early recognition and treatment is needed.

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甲状腺功能亢进和甲状腺毒症中的韦尼克脑病：一项系统综述

背景：甲状腺功能亢进和甲状腺毒症增加了对维生素B1（硫胺素）的代谢需求，使患者面临由严重硫胺素缺乏引起的韦尼克脑病（WE）的风险。本文综述了甲状腺机能亢进和甲状腺毒症的WE症状。使用PubMed、Embase和Scopus对相关病例报告进行系统综述。16例WE合并甲状腺功能亢进或甲状腺毒症。常见因素包括体重减轻（16/16例）、呕吐（12/16例）和妊娠剧吐（11/16例）。11例出现完整的WE三联征，所有检测病例的MRI显示典型的丘脑高强度（12/12）。7例恢复不完全，其中3例进展为慢性Korsakoff综合征。硫胺素处理差异显著。结论甲状腺功能亢进和甲状腺毒症增加了硫胺素缺乏的风险，尤其是体重减轻或呕吐。主动监测和预防性硫胺素治疗对这些患者至关重要。随着时间的推移，WE的症状变得越来越突出，并导致不良后果，需要早期识别和治疗。

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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Thyroid Science

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