Featured Research

from universities, journals, and other organizations

Selenium deficiency may cause cardiomyopathy post-gastric bypass

Date:
October 22, 2012
Source:
American College of Gastroenterology (ACG)
Summary:
Non-compliance with vitamin and mineral supplementation protocols after bariatric surgery could lead to nutritional deficiencies and related health complications, such as heart damage, according to two separate case reports.

Non-compliance with vitamin and mineral supplementation protocols after bariatric surgery could lead to nutritional deficiencies and related health complications, such as heart damage, according to two separate case reports unveiled October 22 at the American College of Gastroenterology's (ACG) 77th Annual Scientific meeting in Las Vegas.

Case Report 1: "Malnutrition Secondary to Non-Compliance with Vitamin and Mineral Supplements after Gastric Bypass Surgery: Complex Problem, Simple Solution"

Multivitamin supplementation is considered the standard of care for any patient undergoing gastric bypass, according to researchers from the University of Missouri who report a case of a non-compliant patient who failed to maintain regular follow-up after undergoing bariatric surgery leading to severe vitamin and mineral deficiencies managed by a multidisciplinary approach.

In this case, a 38-year old female patient underwent Roux-en-Y (RYGB) gastric bypass surgery but had limited follow-up during the five years since her surgery when she presented with several weeks of fatigue. She lost nearly 104 pounds since her surgery and was poorly compliant with her vitamin and mineral supplements, according to co-investigator Hazem Hammad, M.D.

"When she came in for medical care she was pale and had a slight soft ejection systolic murmur," said Dr. Hammad, who noted that she had hemoglobin of 4.7 g/dL and marked mineral and vitamin deficiencies, including low levels of Vitamin B12, Vitamin D, Zinc, and Iron. After receiving counseling about the crucial benefits from long term follow-up and compliance with vitamin supplements, the patient was discharged to complete an IV iron supplementation treatment course and to follow up with a bariatric surgery multidisciplinary center, according to the case report. Two weeks following discharge she received additional counseling from her primary care physician and was given a handout that outlined vitamin supplementation following bariatric surgery along with written information that included how to obtain bariatric vitamins via website, phone and from pharmacies.

Three months following discharge laboratory tests revealed an increase in hemoglobin to 10.8 g/dL and an improvement in her vitamins and mineral deficiency status.

"The pre- and post-operative management of bariatric surgery patients is clearly multidisciplinary. United States guidelines define the primary team as comprising the bariatric surgeon, the obesity specialist and the dietitian," said Dr. Hammad. "Primary care physicians, however, have a significant role in managing and following these patients by providing crucial patient education and support as illustrated in our case."

Selenium Deficiency Causing Cardiomyopathy in a Patient with Gastric Bypass Surgery

In a separate case report, Mustafa Huseini, M.D., Naeem Raza, M.D. and their colleagues from the Geisinger Medical Center in Danville, PA reported that although rare in developed countries, selenium deficiency may occur in individuals with chronic malabsorptive states such as patients with history of gastric bypass, and long term selenium-deficient parenteral nutrition.

"Selenium is an essential trace element that plays an integral role in normal myocardial function so supplementation may be beneficial for individuals who are at risk of low absorption, such as gastric bypass patients," said Dr. Huseini.

He described the case of a 39 year-old female who underwent gastric bypass 7 years before presenting to the emergency department for evaluation of change in mental status, generalized weakness and several days of poor oral intake. On initial evaluation patient was noted to be hypotensive and in mild respiratory distress. After 2 days of hospital admission, she developed respiratory and circulatory collapse requiring endotracheal intubation and mechanical ventilation. A 2D echocardiogram showed a left ventricular ejection fraction of less than 20%. A cardiac catheterization revealed non-obstructive coronary artery disease. Nutritional evaluation revealed decreased levels of selenium (29 mcg/L ; Normal values: 63-160 mcg/L).

"After adequate supplementation with selenium, cardiac function improved and a repeat 2D echocardiogram demonstrated normalized ejection fraction of 55 percent," said Dr. Huseini. "This case emphasizes the role of considering selenium deficiency as a reversible cause of unexplained cardiomyopathy in patients with gastric bypass besides otherwise impaired nutritional status."


Story Source:

The above story is based on materials provided by American College of Gastroenterology (ACG). Note: Materials may be edited for content and length.


Cite This Page:

American College of Gastroenterology (ACG). "Selenium deficiency may cause cardiomyopathy post-gastric bypass." ScienceDaily. ScienceDaily, 22 October 2012. <www.sciencedaily.com/releases/2012/10/121022081226.htm>.
American College of Gastroenterology (ACG). (2012, October 22). Selenium deficiency may cause cardiomyopathy post-gastric bypass. ScienceDaily. Retrieved July 29, 2014 from www.sciencedaily.com/releases/2012/10/121022081226.htm
American College of Gastroenterology (ACG). "Selenium deficiency may cause cardiomyopathy post-gastric bypass." ScienceDaily. www.sciencedaily.com/releases/2012/10/121022081226.htm (accessed July 29, 2014).

Share This




More Health & Medicine News

Tuesday, July 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins