Peripheral Neuropathy after Bariatric Surgery without Nutritional Assesment Due to Vitamin B12 Deficiency (P06.151)

Abstract

Objective: To present 5 consecutive cases of peripheral neuropathy secondary to bariatric surgery without proper nutritional assesment. Background Mexico is among the 5 highest obesity prevalence in the world. Bariatric surgery has become very popular in the country for the treatment of morbid obesity. Some of these procedures are performed without any regulatory triage nor nutritional assesment after surgery resulting in vitamin B12 deficiency and secondary peripheral neuropathy, which is considered to be a ganglionopathy. Literature reports that the most common type is sensorial neuropathy with predominant axonal component. This particular neuropathy is reversible if adequate treatment is initiated in time. Design/Methods: 5 consecutive cases were analyzed by the neurophysiology department, all of them submited to bariatric surgery within 2 years and with alleged lack of nutritional assesment. Inclusion criteria included consecutive cases with bariatric surgery and serum vitamin b12 levels avialable. All of them had B12 levels reported. Statistical analysis methods used were mean, median and parametric measurements. the study design is a transversal, observational study. Results: 5 cases, 4 men 1 woman with an average age 40.Mean B12 levels 69.8 (4-180)±60. Hb 11.14 ±1.55. Hemoglobin volume size 105 ±28.4 HCM 35.4 ±10.5 Fe: 84.32 ±49.00. Neurophisiological studies showed 4 cases of severe axonal polyneuropathy and 1 case of medium axonal sensorial neuropathy. 100% of the consecutive cases fullfilling the inclusion criteria had axonal neuropathy. Conclusions: Axonal neuropathy is a common complication in bariatric surgery patients with vitamin b12 deficiency due to absent or minimal nutritional assesment after surgery. This results endulge a warning sign to local medical council and arises the need of a more strict triage methods and nutritional assesment as well as a mandatory miltidisciplinary comitee surounding patient9s triage and follow up. Disclosure: Dr. Gien-Lopez has nothing to disclose. Dr. Estanol has nothing to disclose.