Intestinal bypass syndrome presenting as erythema nodosum.
Intestinal bypass was a popular surgical procedure for morbid obesity resulting, on average, in a 50 kg weight loss. We describe a 66-year-old woman who underwent the procedure 12 years earlier and subsequently presented with recurrent episodes of erythema nodosum-like lesions. Further investigations revealed hyperoxaluria, renal failure, deficiency of fat-soluble vitamins (causing night blindness, osteomalacia and easy bruising) and anaemia. Antibiotics led to only temporary remission and, as with 24-30% of similar cases, she underwent surgical reversal to prevent the complications from worsening.
Katugampola
R P
RP
Welsh Institute of Dermatology, University Hospital of Wales, Cardiff, Wales. GSRS@katugampola.freeserve.co.uk
Patel
G K
GK
Farrell
A M
AM
D000368:Aged; D001361:Avitaminosis / Q000209:etiology; D004893:Erythema Nodosum / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D006959:Hyperoxaluria / Q000209:etiology; D007581:Jejunoileal Bypass / Q000009:adverse effects*; D008286:Malabsorption Syndromes / Q000209:etiology; D012008:Recurrence; D012086:Reoperation; D013577:Syndrome