[Fatal nutrient deficiencies after gastric bypass]

Area of Science:

• Gastroenterology
• Endocrinology
• Nutritional Science

Background:

• Bariatric surgery is a highly effective obesity treatment.
• Post-gastric bypass surgery, patients are at high risk for micronutrient deficiencies.
• These deficiencies can lead to severe, life-threatening complications.

Observation:

• A 55-year-old woman presented with psychomotor retardation, edema, and rash.
• She rapidly developed pancytopenia, encephalopathy, and heart failure, progressing to multiorgan dysfunction.
• Retrospective analysis revealed severe selenium and niacin deficiencies.

Findings:

• The patient's condition was attributed to severe selenium deficiency causing cardiomyopathy and niacin deficiency leading to pellagrous encephalopathy.
• The deficiencies resulted in neurological, dermatological, and cardiac manifestations.
• The case highlights the potential for rapid deterioration due to untreated micronutrient deficiencies.

Implications:

• Micronutrient levels should be routinely assessed in patients with a history of bariatric surgery presenting with new symptoms.
• Selenium deficiency must be considered in patients with heart failure post-bariatric surgery.
• Early diagnosis and supplementation are vital to prevent severe complications and mortality.