Transketolase abnormality in tolazamide‐induced Wernicke's encephalopathy

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Abstract
We studied a thiamine-dependent enzyme, transketolase, from fibroblasts of a diabetic patient who developed Wernicke9s encephalopathy when treated with tolazamide, in order to delineate if this patient also had transketolase abnormality [high KM for thiamine pyrophosphate (TPP)], as previously reported in postalcoholic Wernicke-Korsakoff syndrome. In addition to this patient, we also studied this enzyme from three diabetic kindreds without any history of Wernicke9s encephalopathy and from four normal controls. We found that the above-mentioned patient and one of the diabetic kindreds with no history of Wernicke9s encephalopathy had abnormal transketolase as determined by its KM for TPP. These data suggest a similarity between postalcoholic Wernicke-Korsakoff syndrome and the patient with tolazamide-induced Wernicke9s encephalopathy from the standpoint of transketolase abnormality.