Diagnostic Usefulness of Blood Thiamine Levels as Screening Tests for Wernicke’s Encephalopathy in Patients with Alcohol Use Disorder

Abstract

Objectives ： The purpose of this study was to evaluate the utility in measuring the blood thiamine and thiamine pyrophosphate (TPP) levels as screening tests for Wernicke encephalopathy in patients with alcohol use disorder. Methods ： We analyzed the demographic, clinical and laboratory data from 35 patients with alcohol use disorder. The blood thiamine and TPP levels were acquired at admission prior to initiation of thiamine intravenous (IV) therapy. We examined whether the blood thiamine and TPP levels correlated with clinical symptoms by apply-ing the Caine’s criteria. Patients who met at least one of Caine’s criteria were considered at high risk for Wernicke encephalopathy and were treated with high-dose thiamine IV therapy. Results ： There was no correlation between blood thiamine/TPP levels and clinical symptoms of Wernicke encephalopathy. Clin-ical manifestations of the below-normal TPP-level group were not different from the normal TPP-level group, except that the normal TPP-level group showed a higher revised clinical insti-tute withdrawal assessment for alcohol (CIWA) scores. Conclusion : Measuring blood thiamine/TPP levels was not sensitive as screening tests for Wernicke encephalopathy among patients with alcohol use disorder. High-dose thiamine IV therapy improved the clinical symptoms of Wernicke encephalopathy in patients with alcohol use disorder.Objectives ： The purpose of this study was to evaluate the utility in measuring the blood thiamine and thiamine pyrophosphate (TPP) levels as screening tests for Wernicke encephalopathy in patients with alcohol use disorder. Methods ： We analyzed the demographic, clinical and laboratory data from 35 patients with alcohol use disorder. The blood thiamine and TPP levels were acquired at admission prior to initiation of thiamine intravenous (IV) therapy. We examined whether the blood thiamine and TPP levels correlated with clinical symptoms by apply-ing the Caine’s criteria. Patients who met at least one of Caine’s criteria were considered at high risk for Wernicke encephalopathy and were treated with high-dose thiamine IV therapy. Results ： There was no correlation between blood thiamine/TPP levels and clinical symptoms of Wernicke encephalopathy. Clin-ical manifestations of the below-normal TPP-level group were not different from the normal TPP-level group, except that the normal TPP-level group showed a higher revised clinical insti-tute withdrawal assessment for alcohol (CIWA) scores. Conclusion : Measuring blood thiamine/TPP levels was not sensitive as screening tests for Wernicke encephalopathy among patients with alcohol use disorder. High-dose thiamine IV therapy improved the clinical symptoms of Wernicke encephalopathy in patients with alcohol use disorder.