Wernicke's Encephalopathy and High-Dose Nitroglycerin

Letters and Corrections1 January 1985Wernicke's Encephalopathy and High-Dose NitroglycerinALAN M. NADEL, M.D.ALAN M. NADEL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-1-134_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The long-recognized cause of Wernicke-Korsakoff encephalopathy has been thiamine deficiency, associated with poor nutrition in the alcoholic or nonalcoholic patient. Blass and Gibson (1) suggested a different cause, namely a genetic abnormality in transketolase, the thiamine-requiring enzyme. Even in their four patients, however, nutritional deprivation was necessary before the genetic expression appeared. Hence, nutritional deprivation has been a common theme in this disease.Shorey and associates (2) propose that high doses of the diluent ethyl alcohol and propylene glycol given intravenously may produce this disease by a direct metabolic effect on thiamine metabolism. These authors should exclude...References1. BLASSGIBSON JG. Abnormality of a thiamine-requiring enzyme in patients with Wernicke-Korsakoff syndrome. N Engl J Med. 1977;297:1367-1370. CrossrefMedlineGoogle Scholar2. SHOREYBHARDWAJLOSCALZO JNJ. Acute Wernicke's encephalopathy after intravenous infusion of high-dose nitroglycerin. Ann Intern Med. 1984;101:500. LinkGoogle Scholar3. PHILLIPSVICTORADAMSDAVIDSON GMRC. A study of nutritional defect in Wernicke's syndrome: the effect of a purified diet, thiamine, and other vitamins on the clinical manifestations. J Clin Invest. 1952;31:859-71. CrossrefMedlineGoogle Scholar4. ZIPORINNUNESPOWELLWARINGSAUBERLICH ZWRPH. Excretion of thiamine and its metabolites in the urine of young adult males receiving restricted intakes of the vitamin. J Nutr. 1965;85:287-96. CrossrefMedlineGoogle Scholar5. NADELBURGER AP. Wernicke encephalopathy following prolonged intravenous therapy. JAMA. 1976;235:2403-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: P. O. Box 41619; Memphis, TN 38174 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntravenous Nitroglycerin Administration and EthanolJ. M. OHAR, M.D., A. A. FOWLER, M.D., J. B. SELHORST, M.D., F. L. GLAUSER, M.D. 1 January 1985Volume 102, Issue 1Page: 134-134KeywordsAlcoholicsBrain diseasesEnzymesEthanolGeneticsMetabolic disordersNutritionThiamine Issue Published: 1 January 1985 PDF downloadLoading ...