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KMID : 0359920070260020274
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Korean Journal of Nephrology
2007 Volume.26 No. 2 p.274 ~ p.278
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A Case of Acute Renal Failure with Wernicke’s Encephalopathy and Beriberi due to Severe Hyperemesis Gravidarum
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Seok Hyun-Jung
Choi Jung
Kim Jung-Wook
Kim Soon-Bae
Park Su-Kil
Park Jung-Sik
Lee Sang-Koo
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Abstract
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Severe hyperemesis gravidarum (HG) is a rare but potentially devastating complication of pregnancy. It can cause dehydration, electrolyte imbalance, malnutrition (especially, thiamine deficiency), and compromised renal function. We report a case of acute renal failure (ARF) with Wernicke’s encephalopathy and beriberi due to severe HG. A 35-year-old woman at 16 weeks of gestation presented with confused mentality, quadriparesis, nystagmus, peripheral neuropathy, and tachycardia after prolonged nausea and vomiting. Her initial serum creatinine and blood urea were 2.6 mg/dL and 100 mg/dL, respectively. FLAIR image of the initial MR examination demonstrated bilateral symmetric high signal intensities in the medial and dorsal thalami. Echocardiography showed left ventricular dilatation and dysfunction. We thought that ARF, Wernicke’s encephalopathy and beriberi were resulted from dehydration and thiamine deficiency due to HG. She was managed with intravenous fluid and 100-200 mg of parenteral thiamine. ARF was improved within one week and echocardiographic findings were normalized within 1 month. MR examination at the 21st week of pregnancy showed a decreased size of the lesion. After 4 months, her neuroloic status was recovered.
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KEYWORD
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Wernicke’s encephalopathy, Acute renal failure, Hyperemesis
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