Roux-en-Y gastric bypass in a patient with Wilson’s disease and obesity

Section snippets

Clinical case presentation

A 29-year-old woman with a body mass index (BMI) of 38.4 kg/m², glucose intolerance, and irregular menstrual cycles was referred to our specialized obesity center. Two years earlier, she was diagnosed with WD. The patient presented without any neurological or psychiatric complications. The initial liver biopsy revealed a pattern of steatohepatitis with periportal and perisinusoidal fibrosis and some copper deposits (Fig. S1). Intrahepatic copper concentration was 911 μg per g of liver dry

Discussion and conclusion

DPA absorption is strongly influenced by malabsorption states[2]. Ammitzboll et al. evaluated the bioavailability of DPA in patients with progressive systemic sclerosis[8]. The bioavailability was reduced by more than half in the presence of gastrointestinal involvement following impaired drug absorption and/or increased degradation in the gastrointestinal tract. Copper absorption primarily occurs in the duodenum and the small bowel, and malabsorptive bariatric surgery may reduce dietary copper

Consent

The patient provided written informed consent to this report.

Data availability

Not applicable

Authors contributions

DM, CS, HC, and AS were implicated in the management of the patient before and after the surgery. AB, CS and AS acquired the data. All authors analysed and interpreted the data. AB, DM and AS contributed to the writing of the first draft of the manuscript. All authors contributed to the critical revision of the manuscript. All authors approved the final version of the manuscript.

Funding

None

Declaration of Competing Interest

None

Acknowledgments

The authors are grateful to the late Professor Peter Ferenci for sharing his expertise in the preoperative evaluation of this patient. The authors thank Cécile Stéphan Moulin, Romina Capoccia Brugger, and SolenneNguyen Gia Can for their dedicated work. Moreover, the authors wish to express their sincere appreciation to Basma Benhaddou and Guy Temporal for the professional proof editing of the manuscript.