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Thiamine deficiency in the bereaved after cancer-related spousal loss

Published online by Cambridge University Press:  20 May 2019

Hideki Onishi ,
Nozomu Uchida ,
Takao Takahashi ,
Daisuke Furuya ,
Yasuhiro Ebihara ,
Izumi Sato ,
Hiroshi Ito  and
Mayumi Ishida
Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Takao Takahashi
Affiliation:
Department of Supportive Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Daisuke Furuya
Affiliation:
Department of General Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Yasuhiro Ebihara
Affiliation:
Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Izumi Sato
Affiliation:
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Hiroshi Ito
Affiliation:
Ito Internal Medicine and Pediatric Clinic, Fukuoka, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Hideki Onishi, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. Email: honishi@saitama-med.ac.jp
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Abstract

Objective

Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer. However, it has not been recognized to date in bereaved partners after spousal loss from cancer.

Method

From a series of bereaved partners who lost a spouse to cancer, we report on those who developed TD after bereavement.

Result

Case 1 was a 57-year-old woman who sought consultation at our “bereavement clinic.” Her husband had been diagnosed with pancreatic cancer one year earlier and had died one month previously. At the first visit, she was observed to suffer depression, anxiety, and decreased appetite. Neurological, blood, and biochemical examinations did not reveal any noteworthy findings. She was diagnosed with uncomplicated bereavement. Detailed examination revealed that her appetite had been markedly decreased for approximately five weeks. The diagnosis of TD was supported by her abnormally low serum thiamine level. Case 2 was a bereaved 73-year-old male who had lost his wife to hypopharyngeal cancer one month previously after a five-year illness. He had shown a lack of energy for the month preceding his wife's death, but because there was no improvement after her death, his family recommended he seek consultation at our “bereavement clinic.” He was suffering from major depressive disorder. Detailed examination revealed that his appetite had been decreased for more than two weeks. Again, the diagnosis of TD was supported by his abnormally low serum thiamine level.

Significance of results

These reports demonstrate that there is a possibility that bereaved could develop TD after the loss of a loved one. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of the bereaved to prevent complications because of TD.

Keywords

Thiamine deficiencyCancerBereavementWernicke's encephalopathySpouse
Type
Case Report
Information
Palliative & Supportive Care , Volume 17 , Issue 6 , December 2019 , pp. 738 - 740
Copyright
Copyright © Cambridge University Press 2019 

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