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Mauhin W, Bouzidi H, Colson A, Lejour G, Miao Y, Montagner C, London J, Subran B, Amathieu R, Lazard T, Lidove O. [Fatal nutrient deficiencies after gastric bypass]. Rev Med Interne 2021; 42:729-733. [PMID: 34144843 DOI: 10.1016/j.revmed.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/01/2021] [Accepted: 05/09/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bariatric surgery is a very effective treatment for obesity. After gastric bypass, micronutrient deficiencies frequently occur which can have dramatic consequences. CASE REPORT We report the case of a 55-year-old woman who was admitted for psychomotor retardation, bilateral leg pitting edema and psoriasis-like rash that had been ongoing for 3 months. Pancytopenia, encephalopathy and heart failure rapidly occurred leading to multiorgan dysfunction syndrome and death. We retrospectively identified severe selenium deficiency with possible secondary cardiomyopathy, niacin deficiency resulting in pellagrous encephalopathy with skin lesions and gelatinous transformation of bone marrow. CONCLUSION Micronutrient deficiency should systematically be assessed when new symptoms occur in a patient with a history of bariatric surgery. Selenium deficiency should be considered in the presence of any heart failure in this context.
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Affiliation(s)
- W Mauhin
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France.
| | - H Bouzidi
- Service de réanimation, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - A Colson
- Service transversal de nutrition et diététique, Paris, France
| | - G Lejour
- Service de réanimation, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - Y Miao
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - C Montagner
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - J London
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - B Subran
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - R Amathieu
- Service de réanimation, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - T Lazard
- Service de réanimation, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
| | - O Lidove
- Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France
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