The Critical Need for Close Follow-Ups After Bariatric Surgery: A Case of Double Complication Involving Acute Gout Attack Followed by Paralytic Axonal Polyneuropathy.

Abstract: Neurological complications of bariatric surgery (BS) are often associated with micronutrient deficiencies secondary to postoperative malabsorption, but Guillain-Barré syndrome-like immune and neuro-inflammatory processes may also play a role in the pathogenesis of neuronal damage. Gout is one of the metabolic complications with an increased frequency in the early period after BS. A young adult male patient with a body mass index of 60 experienced a de novo gout attack six weeks after gastric BS. In the following months, he became non ambulatory and the patient was diagnosed with severe axonal sensorimotor polyneuropathy at our hospital. Following the administration of intravenous immunoglobulin and intensive neurorehabilitation, he made a full recovery with minimal sequelae and was able to walk without assistance or orthosis. To avoid and better manage possible post BS complications, it is imperative to provide close follow-up checks to patients especially in the first year after BS.