American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2016, 4(2), 48-50
DOI: 10.12691/ajmcr-4-2-4
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Ascending Sensory Neuropathy caused by Mild Thiamine Deficiency after Gastric Bypass Surgery

Hassan Tahir1, , Saad Ullah1, Hassan Zeb1, Muhammad Naeem1 and Vistasp Daruwalla2

1Department of Internal Medicine, Temple University/Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA 15905, USA

2Department of Radiology, Wayne State University/Detroit Medical Center, 4201 St Antoine St, Detroit, MI 48201, USA

Pub. Date: February 25, 2016

Cite this paper:
Hassan Tahir, Saad Ullah, Hassan Zeb, Muhammad Naeem and Vistasp Daruwalla. Ascending Sensory Neuropathy caused by Mild Thiamine Deficiency after Gastric Bypass Surgery. American Journal of Medical Case Reports. 2016; 4(2):48-50. doi: 10.12691/ajmcr-4-2-4


Bariatric surgery is the current modality of choice for weight loss in morbid obese patients. Although bariatric surgery is well known to improve obesity related complications, however, patients may be affected by early and late complications. Nutritional deficiency is one of the late complications of bariatric surgery which is more common in patients who are non compliant with dietary recommendations. American Society for Metabolic & Bariatric Surgery stresses the importance of long term regular follow up for dietary adherence assessment and nutritional deficiency screening tests. Thiamine deficiency, though rare, is increasingly seen due to increasing population of patients with gastric bypass surgery. Thiamine deficiency after bariatric surgery usually presents with neurological symptoms, most commonly as Wernicke Encephalopathy or dry Beriberi, and in almost all such cases, thiamine deficiency is very severe. Isolated ascending sensory neuropathy is a very rare presentation, which was seen in out patients with mildly low thiamine levels.

Ascending Sensory Neuropathy Bariatric Surgery Thiamine deficiency Vitamin B1

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[1]  Thiamine Deficiency Secondary to Anorexia Nervosa: An Uncommon Cause of Peripheral Neuropathy and Wernicke Encephalopathy in Adolescence William Renthal, MD, PhDa, , Isaac Marin-Valencia, MDa, b, Patricia A. Evans, MD, PhDa, b).
[2]  Russell RM, Suter PM. Chapter 74. Vitamin and Trace Mineral Deficiency and Excess. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.Harrison’s Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.
[3]  Danielle A. Becker, Laura J. Balcer, and Steven L. Galetta, “The Neurological Complications of Nutritional Deficiency following Bariatric Surgery,” Journal of Obesity, vol. 2012, Article ID 608534, 8 pages, 2012.
[4]  Koffman, B. M., Greenfield, L. J., Ali, I. I. and Pirzada, N. A. (2006), Neurologic complications after surgery for obesity. Muscle Nerve, 33: 166-176.
[5]  G Abdeen., CW le Roux.:Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review. Obesity Surgery. PMID:26530712.
[6]  Anne F. Landais. : Rare neurologic complication of bariatric surgery: acute motor axonal neuropathy (AMAN), a severe motor axonal form of the Guillain Barré syndrome. Surgery for Obesity and Related Diseases , Volume 10 , Issue 6 , e85-e87.
[7]  Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring) 2013; 21 Suppl 1:S1.
[8]  Aasheim ET. Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg 2008; 248:714.