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Cystic fibrosis associated with Wernicke’s encephalopathy in an older adult
  1. Nirmal Vijayavel1,
  2. Sung Woo Koh2 and
  3. Elizabeth Leigh Goodman1
  1. 1Internal Medicine, Harbor-UCLA Medical Center Department of Internal Medicine, Torrance, California, USA
  2. 2Hospital Medicine, University of California Irvine, Orange, California, USA
  1. Correspondence to Dr Elizabeth Leigh Goodman; egoodman{at}


Here we report the first case of an association between cystic fibrosis and Wernicke’s encephalopathy. The patient had a history of cystic fibrosis diagnosed in her early 60s associated with pancreatitis and chronic lung disease. She presented with a traumatic hip fracture requiring operative repair. On examination, she was found to have bilateral nystagmus. MRI revealed enhancement of the mammillary bodies. Laboratory results were notable for thiamine deficiency, which in context of the radiographic and physical examination findings, confirmed a diagnosis of Wernicke’s encephalopathy. The cause of her low thiamine was thought to be poor dietary intake, weight loss and malabsorption associated with exocrine pancreatic insufficiency in the setting of a history of recurrent pancreatitis. The patient had complete resolution of her symptoms with the initiation of thiamine supplementation and pancreatic enzymes. Although classically associated with fat soluble vitamin deficiencies, there are increasing reports of water-soluble vitamin deficiencies associated with cystic fibrosis.

  • pancreatitis
  • brain stem / cerebellum
  • vitamins and supplements
  • cystic fibrosis

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  • Contributors SWK and NV drafted the initial manuscript. NV and ELG edited the manuscript. SWK, NV and ELG contributed to the literature search.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.