scholarly journals Acrodermatitis due to zinc deficiency after combined vertical gastroplasty with jejunoileal bypass: case report

2012 ◽  
Vol 130 (5) ◽  
pp. 330-335 ◽  
Author(s):  
Selma Freire de Carvalho Cunha ◽  
Gilson Antônio Pereira Gonçalves ◽  
Julio Sérgio Marchini ◽  
Ana Maria Ferreira Roselino

CONTEXT: Nutritional complications may occur after bariatric surgery, due to restriction of food intake and impaired digestion or absorption of nutrients. CASE REPORT: After undergoing vertical gastroplasty and jejunoileal bypass, a female patient presented marked weight loss and protein deficiency. Seven months after the bariatric surgery, she presented dermatological features compatible with acrodermatitis enteropathica, as seen from the plasma zinc levels, which were below the reference values (34.4 mg%). The skin lesions improved significantly after 1,000 mg/day of zinc sulfate supplementation for one week. CONCLUSIONS: The patient's evolution shows that the multidisciplinary team involved in surgical treatment of obesity should take nutritional deficiencies into consideration in the differential diagnosis of skin diseases, in order to institute early treatment.

2021 ◽  
Vol 12 ◽  
Author(s):  
Aura D. Herrera-Martínez ◽  
Sonia Junquera-Bañares ◽  
Lucía Turrión-Merino ◽  
Francisco Arrieta-Blanco ◽  
José Botella-Carretero ◽  
...  

Bariatric surgery is one of the most effective treatments currently available for obesity and its derived comorbidities. However, complications may occur, especially when malabsorptive surgeries like a biliopancreatic diversion is performed. We present the case of a female patient whose obesity was treated with this technique, and in the 9th year of follow-up developed an extensive dermatitis secondary to zinc deficiency and malnutrition, precipitated by therapeutic non-compliance. A close surveillance of early symptoms and signs of nutritional deficiencies as well as chronic supplementation of vitamins and trace elements is required; this case illustrates the relevance of periodical, lifelong visits to a medical physician with special training and experience in the management of post bariatric surgery patients in order to prevent, diagnosis and early treat related complications.


Author(s):  
Yassmin Salaheldin ◽  
Walid El Ansari ◽  
Esraa Aljaloudi ◽  
Wahiba Elhag

Abstract Introduction Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. Case report We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). Conclusion Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. Level of evidence Level V, case report.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Alana H. Sunbol ◽  
Sarah Almaghrabi ◽  
Shahd J. Al Aslany ◽  
Mashael M. Aldairi ◽  
Sara A. Makhdum ◽  
...  

Surgeries carry a risk of complications. Polyneuropathies, including Guillain-Barré syndrome (GBS), are potential complications of bariatric surgery. The incidence of these conditions is expected to increase as these surgeries become increasingly popular. We present a case report of three patients who developed a polyneuropathy after bariatric surgery. GBS was diagnosed in each patient, with nutritional deficiencies being suspected as a contributing factor. All patients began a 5-day intravenous immunoglobulin course in addition to receiving rehabilitative support, multivitamins, intravenous thiamine, vitamin D (therapeutic dose), and selenium. The patients’ symptoms improved but did not completely resolve. GBS can be a complication of bariatric surgery. Although a clear cause-effect relationship cannot be established for the present cases, the cumulative literature on the subject suggests that it is important to include it as a potential risk when counseling patients for such surgeries.


Author(s):  
Elisangela Mara TRINDADE ◽  
Telma Souza e Silva GEBARA ◽  
Maria Paula Carlini CAMBI ◽  
Giorgio Alfredo Pedroso BARETTA

ABSTRACT Background: Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities. Aim: Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery. Methods: The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. For the qualitative analysis, the Feeding Frequency Questionnaire was used. Results: In the postoperative period, alopecia was the most reported (79.3%), followed by changes in the texture of the nails, both considered predictive of nutritional deficiencies. Changes in the gastrointestinal tract were described in 86.2%, and episodes of dumping were reported in 65.5%. Qualitative analysis has shown reduced daily consumption of sources of animal and plant proteins. Conclusion: After bariatric surgery can occur flatulence, vomiting and dumping syndrome as the most frequent representative symptoms of digestive functional disorders. Alopecia and nail changes are the most important signs of nutritional deficiency. The use of dietary supplements in the postoperative period is scarce and sporadic.


Cosmetics ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Kamal Alhallak ◽  
Adel Abdulhafid ◽  
Salem Tomi ◽  
Dima Omran

Hypodermoclysis is the continuous subcutaneous infusion of a parenteral solution into dermal tissue, which is typically associated with skin lesions and cosmetic issues in the majority of patients. Scarring and pigmentation are two of the potential skin lesions after hypodermoclysis. The way skin diseases and cosmetic issues are treated has altered dramatically as a result of laser technology. This is the first article to our knowledge that describes the treatment of pigmentation and scarring produced by Hypodermoclysis cutaneous damage by using laser treatment. It was vital to select the appropriate endpoint, technology, and configuration parameters. The lesion was completely resolved after five months of treatment with four laser sessions. The first session used a fractional Er-Yag laser to perform cold ablation. The remaining sessions used 1064 and 585 nm Nd-Yag Q-switch lasers to operate in the nanosecond region. To minimize the danger of post-inflammatory hyperpigmentation (PIH), the treated region was prepped between laser treatments with 4% hydroquinone (HQ) cream. Our protocol may reduce scars and pigmentation while minimizing adverse effects and downtime.


2015 ◽  
Vol 8 (1) ◽  
pp. 27 ◽  
Author(s):  
Mauro Akira Suizu ◽  
Romir Rodrigues ◽  
Juliana Isa Beraldo

A obesidade, doença crônica e complexa, acomete cada vez mais a população. Devido ao tratamento difícil, a cirurgia bariátrica, quando indicada, é eficiente, pois apresenta baixos riscos aos pacientes e boa manutenção da perda de peso. Entretanto, deve-se ter atenção no pós-operatório, devido aos efeitos colaterais promovidos pela cirurgia, resultando em modificações metabólicas e falhas nutricionais, decorrente da má absorção de nutrientes, dentre eles, o ferro. O objetivo da pesquisa foi avaliar a prevalência de anemia ferropriva no período de junho a outubro de 2013, com 32 pacientes submetidos à cirurgia bariátrica do tipo Y de Roux, pertencentes à Associação dos Obesos Operados Bariátricos de Paranavaí e Região (AOOB). Após realizarmos um comparativo parcial com os 32 bariátricos da comunidade, verificarmos deficiências nutricionais. Nos 32 pacientes da comunidade, 50% manifestaram anemia, com IMC 23,37 kg/m2 (21,41 ± 25,33) e idade média de 43 anos. Já na AOOB, 31,25% apresentaram anemia (com maior prevalência dois anos após a cirurgia), IMC 29,02 kg/m2 (24,80 ± 33,24) e idade média de 42,96 anos. Nos associados da AOOB, 46,87% possuem intolerância a carne vermelha; 65% usam suplementos nutricionais e a participação nas reuniões mensais variou de 113 a 32 presenças. Apesar do estudo ter revelado índices relevantes de anemia é essencial o acompanhamento pós-operatório, como o realizado pela AOOB, melhorando a qualidade de vida dos pacientes. No entanto, é necessário um estudo mais abrangente, com espaço amostral e período de tempo maior para solidificação das evidências aqui estudadas. Verification of Anemia in Patients with Bariatric Surgery (Roux-En-Y Gastric Bypass) Obesity, a chronic and complex disease, is more and more common in the population. Due to difficult treatment of obesity, bariatric surgery is efficient since it provides a good weight loss with few risks to patients. The post-operation period is important due to the side effects caused by metabolic modifications and nutritional flaws from a bad absorption of nutrients, especially iron. Current research, undertaken between June and October 2013, assesses the prevalence of iron-insufficiency anemia in 32 patients who underwent Roux-en-Y gastric bypass, belonging to the Association of Operated Obese People (AOOB) from the region of Paranavaí PR Brazil. Partial comparative exam with 32 bariatric patients showed nutritional deficiencies, or rather, 50% suffered from anemia, with BMI = 23.37 kg/m2 (21.41 ± 25.33) and average age 43 years, whereas in AOOB, 31.25% were anemic (after two years of surgery), IMC = 29.02 kg/m2 (24.80 ± 33.24) and mean age 42.96 years. Further, 46.87% of AOOB associates were non-tolerant to beef; 65% used nutrition supplements and participation in monthly meetings varied between 113 and 32. In spite of high anemia percentages, the post-operational follow-up is highly important since it improves the patients ́ lifestyle. However, a more comprising analysis is required with a bigger sample and a longer time span for the establishment of evidences.


2020 ◽  
Vol 35 (6) ◽  
pp. e201-e201
Author(s):  
Asma Al Naamani ◽  
Tuqa Al Lawati

Acrodermatitis enteropathica is a rare autosomal recessive disease caused by a genetic mutation leading to zinc deficiency. Clinical manifestation includes skin lesions, diarrhea, and alopecia. We report the case of a two-month-old girl, admitted with erythematous scaly lesions in the neck and vesiculopustular lesions in the perioral region, associated with alopecia and diarrhea. Clinical diagnosis of the disease was made from her first presentation. She was started on zinc therapy and her lesions resolved entirely after one month of treatment.


2021 ◽  
Author(s):  
Han Na Jang ◽  
Sa Hong Kim ◽  
Young Min Cho ◽  
Do Joong Park

Author(s):  
Mauro Lombardo ◽  
Arianna Franchi ◽  
Roberto Biolcati Rinaldi ◽  
Gianluca Rizzo ◽  
Monica D’Adamo ◽  
...  

There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12.


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