What is the role erythrocyte transketolase levels in the workup of Wernicke encephalopathy (WE)?

Updated: Nov 20, 2018
  • Author: Philip N Salen, MD; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Erythrocyte transketolase levels reliably detect thiamine deficiency but are not necessary for the diagnosis of WE. In the erythrocyte transketolase activity assay, the extent of thiamine deficiency is expressed in percentage stimulation compared with baseline levels (the thiamine pyrophosphate effect). Normal values range from 0-15%; a value of 15-25% indicates thiamine deficiency, and a value of greater than 25% indicates severe deficiency. [3]  The erythrocyte transketolase activity assay including thiamine pyrophosphate effect has been replaced by direct measurement of thiamine and its phosphate esters in human blood by high-performance liquid chromatography. [1]


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