Malnutrition-induced myopathy following Roux-en-Y gastric bypass

Area of Science:

• Nutrition and Metabolism
• Neurology
• Gastroenterology

Background:

• Morbid obesity is a growing public health concern, often managed with bariatric surgery.
• Roux-en-Y gastric bypass is a common and effective bariatric procedure.
• Post-surgical complications, including nutritional deficiencies and their consequences, require careful monitoring.

Observation:

• A 42-year-old male patient presented with myopathy after Roux-en-Y gastric bypass surgery.
• The patient exhibited symptoms of muscle weakness despite no identified vitamin or electrolyte deficiencies.
• Muscle biopsy indicated type II fiber atrophy, a characteristic finding in certain myopathies.

Findings:

• Malnutrition, independent of specific vitamin or electrolyte deficits, was identified as the likely cause of the myopathy.
• Continuous enteral feeding led to a significant recovery of muscle function.
• Histopathological examination revealed type II fiber atrophy, consistent with the observed myopathy.

Implications:

• This case underscores the potential for severe myopathy due to malnutrition post-gastric bypass.
• It highlights the critical role of comprehensive nutritional assessment and support following bariatric surgery.
• Early recognition and intervention with nutritional therapy can reverse bariatric surgery-associated myopathy.