Thyrotoxicosis after Gastric Bypass

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acute thyroiditis, some days after undergoing laparo- scopic Roux-en-Y ... bypass, thyrotoxicosis, thyroiditis ... Subacute thyroiditis is an acute inflammatory dis-.
Obesity Surgery, 14, 699-701

Case Report

Thyrotoxicosis after Gastric Bypass João Régis I. Carneiro1; Raul G. A. Macedo2; Vinícius G. Da Silveira3 1Endocrinologist, 2General

3 General by Surgeon Ingenta to(Professor), Bariatric Surgery Unit, Surgeon,Delivered Sarasota Memorial Hospital Medical Library (cid 64008662) Hospital Universitário Clementino Fraga Filho, UFRJ, Rio de Janeiro, Brazil IP: 4.21.209.240 Date: 2004..06..15..19..20.. Obesity surgery is the optimal therapy for morbid Case Report

obesity. A case is presented of a young woman who developed thyrotoxicosis, believed to be part of subacute thyroiditis, some days after undergoing laparoscopic Roux-en-Y gastric bypass. This clinical entity can present difficulties in differential diagnosis from potential postoperative complications. The correct diagnosis and adequate treatment made possible a favorable recovery.

Key wo r d s : Morbid obesity, bari a t ric surgery, gastric bypass, thyrotoxicosis, thyroiditis

Introduction Bariatric surgery currently offers the most efficacious method for treatment of morbid obesity and its co-morbidities, and is being performed according to accepted criteria in many countries.1,2 Candidates for bariatric surgery are those with BMI ³40 kg/m 2 or with BMI >35 with co-morbidities,2,3 who have been refractory to conventional therapies. Despite the growing number of bariatric operations in our country, we did not find any reference to thyroiditis after obesity surgery. We believe that there is no relationship between these variables, but thyroid dysfunction (especially thyrotoxicosis), can offer some difficulty in postoperative management, especially by its similarity to some surgical complications. R eprint requests to: Joao Regis, MD, Vi sc . P i raja 550, 1512/Ipanema, Rio de Janeiro, 22410-002 Brazil. Fax: 25408428;e-mail:[email protected] © FD-Communications Inc.

A 24-year-old female with a long history of morbid obesity (BMI 43.2 kg/m2) underwent laparoscopic Roux-en-Y gastric bypass using the Capella-Fobi technique,4,5 in December 2002, after having failed rep e ated conservative weight loss regi me n s . Preoperative laboratory values included albumin, t hyroid hormo n es, c o ag u l ation studies, g l u co s e, insulin and C-peptide, cholesterol, triglycerides and u ric acid, all within normal ran ge. Ech o cardiogram was normal, and AST (40, normal