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Research Article Open access CC BY 4.0

Wernicke Encephalopathy Presenting with Severe Pancytopenia: A Rare Clinical Association

Jafrin Sadiq Abdul Razack, Noel George Cherian, Syeda Juveria Hussaini, Sarah Elkhawaga, Ajimal Sainu, Ahmad El-Ouweini

Asian Journal of Research and Reports in Neurology · pp. 144–150 · Published 18 Apr 2025

10.9734/ajorrin/2025/v8i1131

Abstract

Wernicke's encephalopathy (WE) is a severe neurological disorder caused by thiamine deficiency, commonly associated with chronic alcoholism. Early recognition and treatment are critical to prevent irreversible neurological damage. We present a case of a 38-year-old male with chronic alcoholism and fatty liver disease who presented with confusion, ataxia, and hematological abnormalities. Initial investigations revealed anemia, thrombocytopenia, and elevated inflammatory markers. MRI findings were consistent with Wernicke's encephalopathy. The patient received intravenous thiamine, antibiotics, and supportive care. Despite complications including severe pancytopenia and pneumonia, he showed clinical improvement with multidisciplinary management. This case underscores the importance of prompt diagnosis, aggressive thiamine supplementation and vigilant monitoring in the management of WE, particularly in atypical presentations.

Wernicke's encephalopathy (WE) neurological disorder thiamine deficiency thrombocytopenia hematological abnormalities

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