title: Nystagmus: an uncommon neurological manifestation of thiamine deficiency as a serious complication of sleeve gastrectomy.
abstract: Wernicke encephalopathy--a debilitating acute or subacute neurological disorder-is caused by a deficiency in thiamine (vitamin B(1)). It is characterized by a classical clinical triad of symptoms: ocular impairment, cerebellar dysfunction, and confusion. Although bariatric surgery can certainly improve the overall health of an obese individual, it can also make him or her more susceptible to serious nutrition deficiencies. Following surgery, inadequate caloric intake, rapid and excessive weight loss, food intolerance, lack of adherence to nutrition supplementation, and/or the onset of prolonged vomiting can lead to severe nutrition deficiencies. It is generally believed that the more malabsorptive the surgery proves, the more likely is it that such a deficiency will occur. The case presented here shows that after sleeve gastrectomy (SG), a patient may also develop dangerous nutrition deficits that can negatively affect his or her life. In this particular case, a patient presented with a severe vitamin B(1) deficiency following SG for morbid obesity. Although patients may exhibit pathophysiologies similar to Wernicke encephalopathy after this surgery, only 2 cases of severe vitamin B(1) deficiency following sleeve gastrectomy have been reported. The grave consequences of thiamine deficiency observed in this patient underscore the importance of supplementation after SG.
authors.affiliation: Obesity Unit, Endocrinology and Diabetes Department, Hospital Clínic Universitari, Villarroel 170, 08036 Barcelona, Spain. vmoize@clinic.ub.es
authors.forename: Violeta
authors.initials: V
authors.lastname: Moizé
authors.forename: Ainitze
authors.initials: A
authors.lastname: Ibarzabal
authors.forename: Bernardo
authors.initials: B
authors.lastname: Sanchez Dalmau
authors.forename: Lilliam
authors.initials: L
authors.lastname: Flores
authors.forename: Alba
authors.initials: A
authors.lastname: Andreu
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacy
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
mesh_terms: D000328:Adult; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000503:physiopathology; D009767:Obesity, Morbid / Q000601:surgery; D010349:Patient Compliance; D013831:Thiamine / Q000008:administration & dosage*; D013832:Thiamine Deficiency / Q000209:etiology* / Q000503:physiopathology; D015431:Weight Loss; D014899:Wernicke Encephalopathy / Q000150:complications*
chemical_list: D004044:Dietary Proteins; D013831:Thiamine