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Thiamine deficiency in hematologic malignant tumors
Author(s) -
van Zaanen H. C. T.,
van der Lelie J.
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19920401)69:7<1710::aid-cncr2820690711>3.0.co;2-d
Subject(s) - thiamine , medicine , thiamine pyrophosphate , thiamine deficiency , myeloid leukemia , heart failure , gastroenterology , leukemia , pathology , enzyme , biochemistry , chemistry , cofactor
The case is reported of a patient with acute myeloid leukemia with severe right‐sided congestive heart failure that responded to treatment with thiamine. Leukocytes cells contain relatively high concentrations of thiamine‐dependent enzymes compared with erythrocytes. Because no other cause could be found, it was postulated that consumption of thiamine by blast cells was responsible for the deficiency. After studying this patient, the thiamine pyrophosphate (TPP) effect was measured in five other consecutive patients with fast‐growing hematologic malignant tumors. In two patients, the TPP effect was elevated slightly, but another patient had a definite thiamine deficiency with severe cardiac failure. It is suggested that the clinician be alert for this underdiagnosed potentially fatal but easily treatable deficiency in nonalcoholic patients with fast‐growing hematologic cancers.