Premium
Metformin‐induced encephalopathy: the role of thiamine
Author(s) -
McGarvey Caoimhe,
Franconi Catherine,
Prentice David,
Bynevelt Michael
Publication year - 2018
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13693
Subject(s) - medicine , metformin , thiamine , encephalopathy , anorexia , parkinsonism , wernicke's encephalopathy , magnetic resonance imaging , weight loss , diabetes mellitus , gastroenterology , endocrinology , thiamine deficiency , radiology , disease , obesity
A case of metformin encephalopathy is presented in a patient on haemodialysis for end‐stage diabetic renal failure. The patient presented with frequent falls and clinical signs of Parkinsonism, on a background of recent anorexia and significant weight loss. Magnetic resonance imaging showed bilateral, symmetrical abnormalities centred on the lentiform nuclei. Metformin was withheld and signs and symptoms quickly resolved. We hypothesise that metformin may cause thiamine deficiency in patients with end‐stage renal failure resulting in a specific metabolic encephalopathy.