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- Title
La enfermedad de Whipple después de cirugía bariátrica: de la malabsorción a la malnutrición.
- Authors
Zubiaga, Lorea; Ruiz-Tovar, Jaime; Castro, María J.; Ortiz-de-Solózano, Francisco J.; Luque-de-León, Enrique; Jiménez, Jose M.; Carbajo, Miguel Á.; Zubiaga Toro, Lorea; Ortiz de Solórzano, Francisco J; Jiménez, José M
- Abstract
<bold>Introduction: </bold>Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions. We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy. Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications.
- Subjects
WHIPPLE'S disease; BARIATRIC surgery; MALABSORPTION syndromes; MALNUTRITION; PROTEINS in the body; OBESITY treatment; SURGICAL complications; ANTIBIOTICS; ACTINOMYCOSIS; GRAM-positive bacteria; LOW-fat diet; DIETARY proteins; MORBID obesity; NUTRITIONAL status; DISEASE complications
- Publication
Nutrición Hospitalaria, 2019, Vol 36, Issue 1, p238
- ISSN
0212-1611
- Publication type
journal article
- DOI
10.20960/nh.02258