Highlights
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Timely copper repletion may yield favorable outcomes in severe copper deficiency–related polyneuropathy.
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Review of prior SG and RYGB cases of copper deficiency–related polyneuropathy and their treatments and outcomes.
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Neurological complication rates following SG and RYGB reported since 1976.
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Reported incidence of copper deficiency between 6 and 24 mo after SG and RYGB.
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Recommended laboratory tests for neurological complications following bariatric surgery.
ABSTRACT
Background
Sleeve gastrectomy (SG) has become the most commonly performed bariatric procedure due to its favorable weight-loss outcomes and lower complication risks. However, serious neurological complications can still occur. We present a case of severe copper deficiency–related polyneuropathy following SG in a 48-y-old man.
Case Presentation
A 48-y-old man underwent laparoscopic SG for morbid obesity. Three months postoperatively, he developed poor oral intake. At 7 mo, he presented with bilateral distal paresthesia and gait disturbance. Symptoms transiently improved after vitamin B supplementation but progressively worsened. At 9 mo, he was admitted with severe polyneuropathy. Laboratory testing revealed marked hypocupremia. Intravenous copper supplementation led to substantial neurological improvement, and he was eventually discharged with neurological improvement.
Literature Review
Four reports involving five cases of polyneuropathy due to copper deficiency after SG or Roux-en-Y gastric bypass were identified in a search of the literature. Additionally, incidence rates of neurological complications and copper deficiency following SG and Roux-en-Y gastric bypass were reviewed.
Conclusions
In this case report, we emphasize vigilance regarding the presence of copper deficiency after SG, demonstrate that timely supplementation improves outcomes, recommend laboratory evaluation when postoperative neurological symptoms occur, and highlight the need for standardized postoperative copper monitoring and dosing guidelines.
https://www.sciencedirect.com/science/article/abs/pii/S0899900725003533
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