[Beriberi after bariatric surgery].
Bariatric 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.


METHODS
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.


CONCLUSIONS
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.
Sint Franciscus Gasthuis, Rotterdam, the Netherlands. r.goselink@sfg.nl
Rianne J M
RJ
Goselink
Joris J
JJ
Harlaar
Frederique H
FH
Vermeij
Ulas L U
UL
Biter
Guido H H
GH
Mannaerts
Tom
T
den Heijer
D050110:Bariatric Surgery / Q000009:adverse effects*; D042241:Early Diagnosis; D006801:Humans; D020915:Korsakoff Syndrome / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011379:Prognosis; D013831:Thiamine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000188:drug therapy / Q000209:etiology*
D013831:Thiamine