PMID- 37754768
OWN - NLM
STAT- Publisher
LR  - 20231020
IS  - 1563-5279 (Electronic)
IS  - 0020-7454 (Linking)
VI  - 133
IP  - 11
DP  - 2023 Dec
TI  - Acute polyneuropathies after bariatric surgery: does immunity play a role? Case 
      series and literature review.
PG  - 1304-1308
LID - 10.1080/00207454.2023.2263811 [doi]
AB  - BackgroundThe incidence of bariatric surgery (BS) is on the rise, and the 
      prevalence of complications associated with this procedure has also increased. 
      The most common neurologic complications of BS are peripheral neuropathy and 
      encephalopathy. In this study, we presented the clinical and electrophysiological 
      courses of five patients with acute-subacute axonal polyneuropathy after 
      BS.MethodWe evaluated neurological examinations, micronutrient deficiencies (B12, 
      folic acid, thiamine, and vitamin D), nerve conduction studies (NCS), and 
      Guillain-Barre syndrome (GBS) disability scores.Cases All patients were female; 
      the average weight loss was 35.2 +/- 7.52 kg, and the CSF protein level was 
      40.98 +/- 6.99 mg/d. All patients underwent vitamin supplementation and physical 
      therapies. The presence of more pronounced axonal involvement in NCS and the 
      higher likelihood of normal CSF protein levels in BS-related acute polyneuropathy 
      patients suggest that the underlying pathogenesis may differ from classical GBS. 
      In the presented studies in the literature, inflammation is frequently observed 
      in nerve biopsies of BS patients, suggesting that both micronutrient deficiencies 
      and immune mechanisms play a role in the pathogenesis. Intravenous immunoglobulin 
      (IVIG) treatment may improve neurologic deficits in patients with GBS-like 
      clinical presentations. In the presented study, three patients were treated with 
      IVIG, while two patients were treated with plasma exchange therapy followed by 
      IVIG. Three cases improved significantly and were able to walk without assistance 
      at one year visit.ConclusionIn patients with bariatric surgery (BS)-associated 
      polyneuropathy, immunotherapy, and intensive pre- and post-operative nutritional 
      management may improve patients' morbidity. Therefore, we suggest close 
      monitoring by a multidisciplinary team for PBS patients.
FAU - Keskin, Ahmet Onur
AU  - Keskin AO
AUID- ORCID: 0000-0002-2942-323X
AD  - Department of Neurology, Baskent University Adana Dr. Turgut Noyan Research 
      Hospital, Yuregir, Adana, Turkey.
FAU - Yerdelen, Deniz
AU  - Yerdelen D
AUID- ORCID: 0000-0001-6799-5100
AD  - Department of Neurology, Baskent University Adana Dr. Turgut Noyan Research 
      Hospital, Yuregir, Adana, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20231020
PL  - England
TA  - Int J Neurosci
JT  - The International journal of neuroscience
JID - 0270707
SB  - IM
OTO - NOTNLM
OT  - Axonal Polyneuropathy
OT  - Bariatric Surgery
OT  - Guillain-Barre syndrome
OT  - intravenous immunoglobulin
EDAT- 2023/09/27 12:41
MHDA- 2023/09/27 12:41
CRDT- 2023/09/27 09:14
PHST- 2023/09/27 12:41 [pubmed]
PHST- 2023/09/27 12:41 [medline]
PHST- 2023/09/27 09:14 [entrez]
AID - 10.1080/00207454.2023.2263811 [doi]
PST - ppublish
SO  - Int J Neurosci. 2023 Dec;133(11):1304-1308. doi: 10.1080/00207454.2023.2263811. 
      Epub 2023 Oct 20.