Rianne J M Goselink, Joris J Harlaar, Frederique H Vermeij, Ulas L U Biter, Guido H H Mannaerts, Tom den Heijer
Sint Franciscus Gasthuis, Rotterdam, the Netherlands. r.goselink@sfg.nl
Nederlands tijdschrift voor geneeskunde 2012Bariatric surgery is in general the only effective treatment for morbid obesity. Bariatric surgery is frequently associated with vitamin and mineral deficiencies which may lead to neurological and other symptoms. We describe a case of severe vitamin B1 (thiamine) deficiency. A 49-year-old man visited the emergency department with acute confusion, muscle weakness in arms and legs and visual impairment after a period of dysphagia and recurrent vomiting. Four months earlier, he had had bariatric gastric sleeve surgery for morbid obesity. Laboratory tests demonstrated that he had vitamin B1 deficiency, in view of which the diagnosis of beriberi and Wernicke encephalopathy was made. Despite normalisation of the vitamin B1 concentration following intravenous supplementation, the muscle strength hardly recovered and the patient developed Korsakov syndrome. For this deficiency there is no other treatment than vitamin B1 supplementation. Timely recognition of vitamin deficiencies and pro-active supplementation are essential in order to prevent serious complications following bariatric surgery.
Rianne J M Goselink, Joris J Harlaar, Frederique H Vermeij, Ulas L U Biter, Guido H H Mannaerts, Tom den Heijer. Beriberi after bariatric surgery]. Nederlands tijdschrift voor geneeskunde. 2012;155(23):A4500
PMID: 22727224
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