Ascending Sensory Neuropathy caused by Mild Thiamine Deficiency after Gastric Bypass Surgery

Abstract

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.