Pharmacological studies on thiamine deficiency. IV. Blood catecholamine content and blood pressure of thiamine deficient rats

Dementia complicated with Takotsubo cardiomyopathy associated with unconsciousness induced by Wernicke's encephalopathy

An 85-year-old woman who had been living alone and eating an unbalanced diet suddenly entered a neighbour's house. Her house was hot and humid due to lack of air conditioning caused by a loss of electrical power. After arrival, the patient exhibited disorientation, paresis of the right upper extremity, a tendency towards right conjugated deviation and perseveration. Electrocardiogram showed ST segment elevation and prolongation of the QT interval. Echocardiography suggested Takotsubo cardiomyopathy. The cardiac wall motion and neurological abnormalities improved after admission. The serum thiamine level was found to be low, which was compatible with a diagnosis of Wernicke's encephalopathy. Hasegawa dementia score was 10 points and the patient was suspected to have frontotemporal dementia. She was transferred to a nursing home with continuing dementia. In this case, psychological stress trigged by poor living circumstances induced by dementia and Wernicke's encephalopathy may result in the occurrence of Takotsubo cardiomyopathy.

Glucose intolerance in thiamine-deficient rats

The mechanism of glucose intolerance in thiamine-deficient rats has been examined. Deficient rats showed marked glucose intolerance. However, the hypoglycaemic effect of insulin (1 i.u. kg−1, i.p.) was similar in the deficient, pair-fed and normal groups, though somewhat weaker in the normal group than in the other two groups. After injection of tolbutamide (40 mg kg−1, i.p.), the hypoglycaemic effects in the three groups were the same. Tyramine (10 mg kg−1, s.c.) restored the impaired glucose tolerance of deficient rats to normal, but not that of alloxan diabetic rats. Furthermore, tyramine did not restore the intolerance of deficient rats pretreated with alloxan. These results suggest that the main factor causing glucose intolerance in the deficient rats may be suppressed insulin secretion.