{"id":"https://openalex.org/W7225318400","doi":"https://doi.org/10.21203/rs.3.rs-11365783/v1","title":"Wernicke encephalopathy complicating hyperemesis gravidarum after delayed thiamine therapy for suspected thiamine allergy: a case report and review of 39 published cases","display_name":"Wernicke encephalopathy complicating hyperemesis gravidarum after delayed thiamine therapy for suspected thiamine allergy: a case report and review of 39 published cases","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225318400","doi":"https://doi.org/10.21203/rs.3.rs-11365783/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11365783/v1","doi":"https://doi.org/10.21203/rs.3.rs-11365783/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11365783/v1","pdf_url":"https://www.researchsquare.com/article/rs-11365783/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-11365783/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5007729340","display_name":"Caiping Ke","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210092091","display_name":"Third Affiliated Hospital of Guangzhou Medical University","ror":"https://ror.org/00fb35g87","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210092091"]},{"id":"https://openalex.org/I92039509","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61","country_code":"CN","type":"education","lineage":["https://openalex.org/I92039509"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Caiping Ke","raw_affiliation_strings":["The Third Affiliated Hospital, Guangzhou Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Third Affiliated Hospital, Guangzhou Medical University","institution_ids":["https://openalex.org/I4210092091","https://openalex.org/I92039509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160964091","display_name":"Lili Lai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I92039509","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61","country_code":"CN","type":"education","lineage":["https://openalex.org/I92039509"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Lili Lai","raw_affiliation_strings":["The Fourth Affiliated Hospital of Guangzhou Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Fourth Affiliated Hospital of Guangzhou Medical University","institution_ids":["https://openalex.org/I92039509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160857456","display_name":"Yi Wu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210092091","display_name":"Third Affiliated Hospital of Guangzhou Medical University","ror":"https://ror.org/00fb35g87","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210092091"]},{"id":"https://openalex.org/I92039509","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61","country_code":"CN","type":"education","lineage":["https://openalex.org/I92039509"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yi Wu","raw_affiliation_strings":["The Third Affiliated Hospital, Guangzhou Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Third Affiliated Hospital, Guangzhou Medical University","institution_ids":["https://openalex.org/I4210092091","https://openalex.org/I92039509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052831418","display_name":"Danhong Feng","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210092091","display_name":"Third Affiliated Hospital of Guangzhou Medical University","ror":"https://ror.org/00fb35g87","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210092091"]},{"id":"https://openalex.org/I92039509","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61","country_code":"CN","type":"education","lineage":["https://openalex.org/I92039509"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Danhong Feng","raw_affiliation_strings":["The Third Affiliated Hospital, Guangzhou Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Third Affiliated Hospital, Guangzhou Medical University","institution_ids":["https://openalex.org/I4210092091","https://openalex.org/I92039509"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160735016","display_name":"Dunjin Chen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210092091","display_name":"Third Affiliated Hospital of Guangzhou Medical University","ror":"https://ror.org/00fb35g87","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210092091"]},{"id":"https://openalex.org/I92039509","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61","country_code":"CN","type":"education","lineage":["https://openalex.org/I92039509"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Dunjin Chen","raw_affiliation_strings":["The Third Affiliated Hospital, Guangzhou Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Third Affiliated Hospital, Guangzhou Medical University","institution_ids":["https://openalex.org/I4210092091","https://openalex.org/I92039509"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12494","display_name":"Alcoholism and Thiamine Deficiency","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12494","display_name":"Alcoholism and Thiamine Deficiency","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13201","display_name":"Infectious Encephalopathies and Encephalitis","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14120","display_name":"Thallium and Germanium Studies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2310","display_name":"Pollution"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/wernicke-encephalopathy","display_name":"Wernicke's encephalopathy","score":0.9980000257492065},{"id":"https://openalex.org/keywords/hyperemesis-gravidarum","display_name":"hyperemesis gravidarum","score":1.0},{"id":"https://openalex.org/keywords/thiamine-deficiency","display_name":"thiamine deficiency","score":0.9380000233650208},{"id":"https://openalex.org/keywords/intravenous-thiamine","display_name":"intravenous thiamine","score":0.8019999861717224},{"id":"https://openalex.org/keywords/pregnancy","display_name":"pregnancy","score":0.6190000176429749},{"id":"https://openalex.org/keywords/korsakoff-syndrome","display_name":"Korsakoff syndrome","score":0.9139999747276306},{"id":"https://openalex.org/keywords/neurological-sequelae","display_name":"neurological sequelae","score":0.6159999966621399},{"id":"https://openalex.org/keywords/mri-findings","display_name":"MRI findings","score":0.3659999966621399}],"concepts":[{"id":"https://openalex.org/C2778409550","wikidata":"https://www.wikidata.org/wiki/Q391556","display_name":"Hyperemesis gravidarum","level":3,"score":0.958899974822998},{"id":"https://openalex.org/C2776203871","wikidata":"https://www.wikidata.org/wiki/Q83187","display_name":"Thiamine","level":2,"score":0.9235000014305115},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8899000287055969},{"id":"https://openalex.org/C2909842389","wikidata":"https://www.wikidata.org/wiki/Q184084","display_name":"Wernicke Encephalopathy","level":3,"score":0.7814000248908997},{"id":"https://openalex.org/C2780852908","wikidata":"https://www.wikidata.org/wiki/Q127076","display_name":"Vomiting","level":2,"score":0.7146999835968018},{"id":"https://openalex.org/C2779234561","wikidata":"https://www.wikidata.org/wiki/Q11995","display_name":"Pregnancy","level":2,"score":0.6312999725341797},{"id":"https://openalex.org/C2778621155","wikidata":"https://www.wikidata.org/wiki/Q576349","display_name":"Encephalopathy","level":2,"score":0.6298999786376953},{"id":"https://openalex.org/C2779533435","wikidata":"https://www.wikidata.org/wiki/Q1573307","display_name":"Wernicke's encephalopathy","level":4,"score":0.6245999932289124},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.49129998683929443},{"id":"https://openalex.org/C46973012","wikidata":"https://www.wikidata.org/wiki/Q28627","display_name":"Gestation","level":3,"score":0.43950000405311584},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.42570000886917114},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.3926999866962433},{"id":"https://openalex.org/C2779761075","wikidata":"https://www.wikidata.org/wiki/Q58952","display_name":"Hiccups","level":2,"score":0.3919000029563904},{"id":"https://openalex.org/C146638467","wikidata":"https://www.wikidata.org/wiki/Q10529587","display_name":"Hyperintensity","level":3,"score":0.3853999972343445},{"id":"https://openalex.org/C2777958118","wikidata":"https://www.wikidata.org/wiki/Q184084","display_name":"Thiamine deficiency","level":3,"score":0.34470000863075256},{"id":"https://openalex.org/C3020471959","wikidata":"https://www.wikidata.org/wiki/Q183206","display_name":"B vitamins","level":2,"score":0.3422999978065491},{"id":"https://openalex.org/C206179267","wikidata":"https://www.wikidata.org/wiki/Q188952","display_name":"Medical history","level":2,"score":0.30059999227523804},{"id":"https://openalex.org/C2780168130","wikidata":"https://www.wikidata.org/wiki/Q2916167","display_name":"Neurological examination","level":2,"score":0.2824999988079071},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.2621000111103058},{"id":"https://openalex.org/C143409427","wikidata":"https://www.wikidata.org/wiki/Q161238","display_name":"Magnetic resonance imaging","level":2,"score":0.2621000111103058}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11365783/v1","doi":"https://doi.org/10.21203/rs.3.rs-11365783/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11365783/v1","pdf_url":"https://www.researchsquare.com/article/rs-11365783/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11365783/v1","doi":"https://doi.org/10.21203/rs.3.rs-11365783/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11365783/v1","pdf_url":"https://www.researchsquare.com/article/rs-11365783/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9922999739646912,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320311429","display_name":"Guangzhou Medical University","ror":"https://ror.org/00zat6v61"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225318400.pdf","grobid_xml":"https://content.openalex.org/works/W7225318400.grobid-xml"},"referenced_works_count":39,"referenced_works":["https://openalex.org/W1629261688","https://openalex.org/W1907317338","https://openalex.org/W1982009815","https://openalex.org/W2020399699","https://openalex.org/W2073290399","https://openalex.org/W2127902263","https://openalex.org/W2322560028","https://openalex.org/W2480989878","https://openalex.org/W2522263602","https://openalex.org/W2546505767","https://openalex.org/W2608770531","https://openalex.org/W2769955740","https://openalex.org/W2775918410","https://openalex.org/W2895017860","https://openalex.org/W2911844087","https://openalex.org/W2920823074","https://openalex.org/W2952631853","https://openalex.org/W3048512202","https://openalex.org/W3083429178","https://openalex.org/W3097744796","https://openalex.org/W3137240304","https://openalex.org/W4211112510","https://openalex.org/W4223468316","https://openalex.org/W4280613482","https://openalex.org/W4294215472","https://openalex.org/W4313249612","https://openalex.org/W4386124149","https://openalex.org/W4387110561","https://openalex.org/W4387617491","https://openalex.org/W4387745020","https://openalex.org/W4391251646","https://openalex.org/W4392437037","https://openalex.org/W4399193532","https://openalex.org/W4401300937","https://openalex.org/W4406080741","https://openalex.org/W4407438768","https://openalex.org/W4412007837","https://openalex.org/W4412079586","https://openalex.org/W7155485986"],"related_works":["https://openalex.org/W6911672884","https://openalex.org/W200275979","https://openalex.org/W4387194106","https://openalex.org/W2920823074","https://openalex.org/W4380872255","https://openalex.org/W4303984387","https://openalex.org/W7115063899","https://openalex.org/W2608770531","https://openalex.org/W2136202224","https://openalex.org/W3085273062"],"abstract_inverted_index":{"Abstract":[0],"Background:":[1],"Hyperemesis":[2],"gravidarum":[3],"(HG)":[4],"is":[5],"a":[6,43,63,111,171,183,234],"common":[7],"cause":[8],"of":[9,73,137,146,173,185,188,198,215,236],"thiamine":[10,33,53,117,212,230,242],"deficiency":[11],"during":[12],"pregnancy":[13],"and":[14,82,98,149,176,249],"may":[15],"progress":[16],"to":[17,140,155],"Wernicke":[18],"encephalopathy":[19],"(WE).":[20],"Most":[21],"treatment":[22],"delays":[23],"arise":[24],"from":[25,152],"missed":[26],"diagnosis,":[27],"but":[28],"iatrogenic":[29],"hesitation":[30],"over":[31],"suspected":[32],"allergy":[34],"has":[35],"rarely":[36],"been":[37],"examined.":[38],"Case":[39],"presentation:":[40],"We":[41,131],"report":[42],"35-year-old":[44],"woman":[45],"with":[46,84,208,223,246],"HG":[47,141],"at":[48,67,170,179],"15+4":[49],"weeks'":[50],"gestation":[51],"whose":[52],"replacement":[54],"was":[55,109,118,165],"withheld":[56],"for":[57],"more":[58],"than":[59],"four":[60],"weeks":[61,175,187],"after":[62,182],"positive":[64,229],"skin":[65,107,231],"test":[66,108,232],"another":[68],"hospital,":[69],"despite":[70],"no":[71],"history":[72,235],"allergy.":[74],"She":[75],"later":[76],"developed":[77],"altered":[78],"consciousness,":[79],"blurred":[80],"vision,":[81],"ataxia,":[83],"brain":[85],"magnetic":[86],"resonance":[87],"imaging":[88],"(MRI)":[89],"showing":[90],"symmetric":[91],"hyperintensities":[92],"in":[93,143,243],"the":[94,106,193],"thalami,":[95],"frontal":[96],"lobes,":[97],"dorsal":[99],"brainstem.":[100],"After":[101],"multidisciplinary":[102],"review":[103],"concluded":[104],"that":[105],"likely":[110],"false-positive":[112],"irritant":[113],"reaction,":[114],"high-dose":[115],"intravenous":[116],"administered":[119],"without":[120,233],"any":[121],"allergic":[122],"response;":[123],"her":[124],"mental":[125],"status":[126],"recovered":[127],"within":[128],"24":[129],"hours.":[130],"also":[132],"reviewed":[133],"39":[134],"published":[135],"cases":[136,159],"WE":[138],"secondary":[139],"identified":[142],"PubMed,":[144],"Web":[145],"Science,":[147],"CNKI,":[148],"Wanfang":[150],"databases":[151],"January":[153],"2016":[154],"June":[156],"2026":[157],"(40":[158],"including":[160,221],"ours).":[161],"The":[162],"mean":[163,172,184],"age":[164],"26.9":[166],"years;":[167],"vomiting":[168,248],"began":[169],"8.1":[174],"neurological":[177,219,250],"symptoms":[178],"15.9":[180],"weeks,":[181],"7.1":[186],"vomiting.":[189],"Only":[190],"55%":[191],"had":[192,217],"complete":[194],"classic":[195],"triad;":[196],"85.3%":[197],"MRI":[199],"scans":[200],"were":[201],"positive.":[202],"Three":[203],"mothers":[204],"died":[205],"(7.5%),":[206],"all":[207],"delayed":[209],"or":[210],"inadequate":[211],"replacement;":[213],"20%":[214],"patients":[216,245],"chronic":[218],"sequelae,":[220],"17.5%":[222],"Korsakoff":[224],"syndrome.":[225],"Conclusions:":[226],"A":[227],"single":[228],"hypersensitivity":[237],"must":[238],"not":[239],"delay":[240],"parenteral":[241],"pregnant":[244],"persistent":[247],"symptoms.":[251]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-06T00:00:00"}