Abstract
A 24-year-old woman with a large cell anaplastic CD 30-positive T-cell non-Hodgkin's lymphoma (NHL) developed downbeat nystagmus, anisocoria, and oscillopsia. Prior to overt cerebral invasion by NHL, she had a thiamine deficiency with very low thiamine concentrations in the CSF, probably caused by protracted vomiting and increased vitamin B1 consumption by intrathecal tumor cells. We believe that her neurologic symptoms were caused -- at least partly -- by thiamine deficiency, as she reacted well to thiamine supplementation at the beginning of treatment.
MeSH terms
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Adult
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Anisocoria / etiology
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Aphasia / etiology
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Bleomycin / administration & dosage
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Brain Neoplasms / complications*
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Brain Neoplasms / diagnosis
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Brain Neoplasms / metabolism
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Cyclophosphamide / administration & dosage
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Cytarabine / administration & dosage
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Dizziness / etiology
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Doxorubicin / administration & dosage
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Etoposide / administration & dosage
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Female
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Granulocyte Colony-Stimulating Factor / therapeutic use
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Hemiplegia / etiology
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Humans
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Lymphoma, Large-Cell, Anaplastic / complications*
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Lymphoma, Large-Cell, Anaplastic / diagnosis
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Lymphoma, Large-Cell, Anaplastic / drug therapy
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Lymphoma, Large-Cell, Anaplastic / metabolism
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Methotrexate / administration & dosage
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Mitoxantrone / administration & dosage
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Neoplastic Stem Cells / metabolism
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Nystagmus, Pathologic / drug therapy
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Nystagmus, Pathologic / etiology*
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Prednisone / administration & dosage
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Remission Induction
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Thiamine / cerebrospinal fluid
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Thiamine / metabolism
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Thiamine / therapeutic use
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Vincristine / administration & dosage
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Vomiting / complications
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Wernicke Encephalopathy / drug therapy
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Wernicke Encephalopathy / etiology*
Substances
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Cytarabine
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Bleomycin
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Granulocyte Colony-Stimulating Factor
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Vincristine
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Etoposide
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Doxorubicin
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Cyclophosphamide
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Mitoxantrone
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Prednisone
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Thiamine
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Methotrexate