Delayed inflammatory leukoencephalopathy after gastric bypass surgery

Area of Science:

• Neurology
• Immunology
• Pathology

Background:

• Bariatric surgery is associated with various complications, including rare neurological sequelae.
• Leukoencephalopathy, a white matter disease of the brain, presents with diverse neurological symptoms.

Observation:

• A female patient developed global language and memory deficits 30 months post-bariatric surgery.
• Diffuse FLAIR hyperintensities in the cerebral white matter (WM) were observed.
• No nutritional deficiencies were detected despite the neurological presentation.

Findings:

• Cerebral WM showed perivascular T-cell infiltrations.
• Axonal amyloid precursor protein (APP) immunoreactivity was prominent, without myelin or neuronal damage.
• These findings suggest a distinct pathological process in the white matter.

Implications:

• The study suggests a potential link between altered immunity and axonal dysfunction in post-bariatric surgery leukoencephalopathy.
• This highlights the need for further investigation into the neurological complications following bariatric procedures.
• Understanding these mechanisms may lead to improved patient monitoring and management strategies.