Bilateral leg oedema after bariatric surgery: A selenium-deficient cardiomyopathy

Massoure, Pierre‐Laurent; Camus, O.; Fourcade, Laurent; Simon, Fabrice

doi:10.1016/j.orcp.2017.05.004

Cited by 19 publications

(9 citation statements)

References 6 publications

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“…Clinically significant selenium deficiency is associated with myopathy, cardiomyopathy, arrhythmia, impaired immunity, hypothyroidism, loss of skin/hair pigmentation, and encephalopathy . Massoure et al reported heart failure in a patient 9 months after RYGB that resolved with 2 μg/kg/d × 3 months oral selenium with furosemide and an angiotensin‐converting enzyme inhibitor. Among 437 patients having LAGB or SG, selenium deficiency (below normal range 0.75 to 1.85 μmol/L) occurred in 2.3% of patients pre‐operatively (3.2% in another, smaller study) , and then, while taking a multivitamin‐mineral supplement, in 14.9% patients at 3 months postoperatively, 13.8% at 6 months, 13.1% at 12 months, 15.4% at 18 months, 11.4% at 24 months, and 14.3% at 36 months .…”

Section: Executive Summarymentioning

confidence: 99%

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

340

464

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Objective The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results New or updated topics in this CPG include: contextualization in an adiposity‐based chronic disease complications‐centric model, nuance‐based and algorithm/checklist‐assisted clinical decision‐making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusions Bariatric procedures remain a safe and effective intervention for higher‐risk patients with obesity. Clinical decision‐making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.

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Section: Executive Summarymentioning

confidence: 99%

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

340

464

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“…The prevalence of selenium deficiency post LSG is 7.1% and post RYGB is 3.8% [26]. A case report described a 40 year-old woman that presented with symptoms of heart failure nine months after RYGB which was confirmed by echocardiography and cardiac markers [42]. The patient was diagnosed with selenium-deficient cardiomyopathy, and she had complete resolution of her symptoms after 3 months of oral selenium [42].…”

Section: Seleniummentioning

confidence: 99%

Nutritional Deficiencies Post Bariatric Surgery: A Forgotten Area Impacting Long-Term Success and Quality of Life

Ansari¹

2021

Bariatric Surgery - From the Non-Surgical Approach to the Post-Surgery Individual Care

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Bariatric surgery (BS) results in significant weight loss and improvement of obesity associated comorbidities. Despite the benefits achieved with these operations, deficiencies of vitamins and other micronutrients are common. Such deficiencies may become clinically significant if not discovered and treated early. Therefore, it is imperative to undertake thorough screening, and have sound preventive strategies in place in order to make BS a safer procedure. This chapter will provide the multidisciplinary bariatric team with a comprehensive review of micronutrient deficiencies before and after bariatric surgery. The focus will be on the most common micronutrient deficiencies that are encountered in various types of BS procedures, including water soluble vitamins, fat-soluble vitamins, minerals and trace elements deficiencies, as well as protein malnutrition. The chapter starts with an overview of the causes of micronutrient deficiencies in patients with obesity and before undergoing BS. It reviews the screening of patients for preexisting micronutrient deficiencies prior to their BS. Then the chapter addresses the potential causes and mechanisms leading to such deficiencies after BS. It then conducts an in depth discourse of the prevalence of deficiencies by the type of BS, the presenting symptoms, and the investigations required for the diagnoses. The chapter will also discuss the management of each deficiency according to the severity of the symptoms. The chapter also reviews the recent updated guidelines for standard nutritional care post BS. We will finally conclude with a framework of the preventive strategies for optimal care to ensure long term success post-surgery.

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“…To et al described three cases of severe dilated cardiomyopathy in intubated patients receiving parenteral nutrition that improved after Se supplementation [ 4 ]. Massoure et al described the case of a 40-year-old patient presenting with dilated cardiomyopathy and Se deficiency following bariatric surgery with a resolution of symptoms after Se repletion [ 2 ]. Saliba et al described a case of Se-deficient cardiomyopathy that was reversible after supplementation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Se deficiency has been reported in regions of the world with selenium-poor soils used for agriculture, commonly in parts of Russia, China, and Europe. The increased incidence of gastrointestinal pathologies, including inflammatory bowel disease, chronic diarrhea, bowel resections for colon cancer, bariatric surgery (for weight loss), and long-term use of parenteral nutrition deficient in Se has led to an increased number of reported cases of Se deficiency in the USA [ 2 - 5 ]. Dilated cardiomyopathy secondary to Se deficiency (i.e., Keshan disease) is a well-recognized outcome and occasionally reversed by Se supplementation [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Rare Cause of Cardiomyopathy: A Case of Selenium Deficiency Causing Severe Cardiomyopathy that Improved on Supplementation

Munguti

Rifai

Shaheen

2017

Cureus

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Selenium-associated cardiomyopathy is a rare but potentially fatal condition that has previously been described in the literature. Once identified, the condition may be reversible via supplementation. Gastrointestinal operations, especially bariatric and bowel resection, are increasingly associated with multiple deficiencies, including a deficiency of the micronutrient selenium (Se). This case report presents a patient with Se-deficient cardiomyopathy whose condition improved due to Se replacement.

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Bilateral leg oedema after bariatric surgery: A selenium-deficient cardiomyopathy

Cited by 19 publications

References 6 publications

Nutritional Deficiencies Post Bariatric Surgery: A Forgotten Area Impacting Long-Term Success and Quality of Life

A Rare Cause of Cardiomyopathy: A Case of Selenium Deficiency Causing Severe Cardiomyopathy that Improved on Supplementation

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