An Autopsy Case of Misdiagnosed Wernicke's Syndrome after Intragastric Balloon Therapy.

Paola Vellante,Aldo Carnevale,Cristian D’Ovidio

doi:10.1155/2018/1510850

Paola Vellante, Aldo Carnevale + Show 1 more

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https://doi.org/10.1155/2018/1510850

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Abstract

Intragastric balloon (IGB) therapy is a widely used technique to counter obesity, and it is known to be safe and effective. Although there can be a high rate of side effects following IGB therapy, most are self-healing and they are mainly accommodative in nature. Few cases of Wernicke's syndrome under IGB therapy have been described in the literature, and to the best of our knowledge, none have been fatal. We present here a case of a 51-year-old woman who underwent IGB therapy over 8 months. Late diagnosed Wernicke's syndrome that first appeared as lower limb neuropathy progressively immobilized the patient, until she required bed rest. Finally, a major complication of pneumonia caused her death. Wernicke's syndrome has been mainly related to bariatric surgery techniques, but it must also be linked to IGB therapy (and also to other restrictive weight-loss interventions). As the use of IGB therapy spreads, the literature must alert physicians to this complication. Wernicke's syndrome is a severe but reversible condition when diagnosed and treated early.

Highlights

Obesity is a growing health problem, and once lifestyle modifications and pharmacotherapies have failed, intragastric balloon (IGB) therapy represents a safe and effective treatment that can be considered before bariatric surgery techniques
IGB therapy is indicated for patients whose body mass index (BMI) is from 30 kg/m2 to 40 kg/m2, to prepare these superobese patients for bariatric surgery
We present here an autopsy case of a 51-year-old woman who underwent IGB therapy

Summary

Introduction

Obesity is a growing health problem, and once lifestyle modifications and pharmacotherapies have failed, intragastric balloon (IGB) therapy represents a safe and effective treatment that can be considered before bariatric surgery techniques. IGB therapy is indicated for patients whose body mass index (BMI) is from 30 kg/m2 to 40 kg/m2, to prepare these superobese patients for bariatric surgery. It represents a temporary treatment of choice. There have been few reported cases of Wernicke’s syndrome related to IGB therapy [3, 4]. In these cases, the diagnosis of Wernicke’s syndrome was made in its early stages and was immediately treated. There are no reports of late Wernicke’s syndrome diagnosis (i.e., after IGB therapy) in the international literature. Patients should be informed that Wernicke’s syndrome can be a side effect of IGB therapy

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