Peripheral neuropathy mimicking Guillain-Barre syndrome in a patient with severe refeeding syndrome: a case report

Abstract

Abstract Background: Refeeding syndrome (RS) is a potentially serious condition and frequently ignored without uniform definition. Severe refeeding syndrome may present with symptoms of thiamine deficiency (TD) with poor outcome. Prevention in high-risk populations and timely treatment of clearly diagnosed patients may improve outcomes.Case presentation: A 58-year-old patient with fulminant myocarditis who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) ran into severe RS during the recovery period after ECMO was successfully removed. Considering thiamine deficiency as a result of severe refeeding syndrome, patients were given empiric thiamine 100mg intramuscularly once a day. The peripheral neuropathy mimicing Guillain-Barre syndrome (GBS), cardiac insufficiency, and hyperlactemia were improved after 5 days following thiamine supplementation.Conclusion: Refeeding syndrome often occurs, and it is very harmful. The clinical manifestations of refeeding syndromes are diverse. Proper management of refeeding syndrome is very important to improve patient outcomes.