{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:10:26Z","timestamp":1771326626778,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Wernicke encephalopathy (WE) is a life\u2010threatening neurological disorder caused by thiamine deficiency, commonly associated with alcoholism but also observed in malnourished pediatric cancer patients undergoing intensive chemotherapy. WE remains underdiagnosed in children, with many cases only confirmed postmortem. We report a 6\u2010year\u2010old girl with acute lymphoblastic leukemia (ALL) who developed WE secondary to treatment\u2010resistant nausea and vomiting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>The patient presented with acute gait disturbance, ophthalmoparesis, and paraparesis following persistent vomiting and significant weight loss. Initial diagnostic evaluations, including cerebrospinal fluid analysis and neuroimaging, suggested alternative diagnoses such as cerebellitis and Guillain\u2010Barr\u00e9 Syndrome. However, progressive neurological deterioration, the emergence of encephalopathy, and follow\u2010up magnetic resonance imaging (MRI) findings of hyperintense lesions in the periventricular, periaqueductal, and cerebellar regions supported the diagnosis of WE. The overlapping features with other neurological conditions contributed to a delay in recognizing WE and initiating thiamine therapy. Despite initiating high\u2010dose intravenous thiamine, symptom resolution was significant but partial. Unfortunately, the patient later developed lymphomatous meningitis and sepsis and ultimately succumbed to complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the importance of early clinical recognition of WE in pediatric leukemia patients with prolonged vomiting, as delayed diagnosis can lead to irreversible neurological damage or death. Given the limitations of early neuroimaging findings, clinical suspicion should prompt immediate thiamine supplementation. The report points out the need for heightened awareness of thiamine deficiency in pediatric oncology, emphasizing the role of prophylactic supplementation in high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70235","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T07:02:41Z","timestamp":1750662161000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Wernicke Encephalopathy in a Child With Acute Lymphoblastic Leukemia: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-4590","authenticated-orcid":false,"given":"Ghazaleh","family":"Shakibamaram","sequence":"first","affiliation":[{"name":"Medical School of Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-4535","authenticated-orcid":false,"given":"Mohammadreza","family":"Dolikhani","sequence":"additional","affiliation":[{"name":"Medical School of Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2137-4907","authenticated-orcid":false,"given":"Farideh","family":"Moussavi","sequence":"additional","affiliation":[{"name":"Pediatric Department Shohada\u2010e Tajrish Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4013-4495","authenticated-orcid":false,"given":"Syna","family":"Sarraf","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit Shohada\u2010e Tajrish Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7988-1179","authenticated-orcid":false,"given":"Bredsin","family":"Benyamin","sequence":"additional","affiliation":[{"name":"Neurology Department Shohada\u2010e Tajrish Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-6425","authenticated-orcid":false,"given":"Soroor","family":"Advani","sequence":"additional","affiliation":[{"name":"Neurology Department Shohada\u2010e Tajrish Hospital, Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"issue":"8","key":"e_1_2_11_2_1","article-title":"Wernicke's Encephalopathy Associated With Transient Gestational Hyperthyroidism and Hyperemesis Gravidarum","volume":"12","author":"Ahmed S.","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-020-00989-3"},{"issue":"1","key":"e_1_2_11_4_1","article-title":"Apathetic Encephalopathy in Thyreotoxicosis: An Unsual Cause of Wernicke Encephalopathy and Osmotic Demyelinating Syndrome","volume":"92","author":"Mutti C.","year":"2021","journal-title":"Acta Biomed"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-014-0506-9"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00037-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-239392"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073813510355"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2011.01.007"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25650"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-693X(97)87238-7"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1713334"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.02.018"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2009.00451.x"},{"issue":"9","key":"e_1_2_11_15_1","article-title":"Wernicke's Encephalopathy in a Patient With Crohn's Disease: A Case Report","volume":"15","author":"Adamou F.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000973"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3152"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2014.08.014"},{"issue":"3","key":"e_1_2_11_19_1","first-page":"S123","article-title":"Pathophysiology of Cerebellar Dysfunction in the Wernicke\u2010Korsakoff Syndrome","volume":"20","author":"Butterworth R. 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