Severe copper deficiency-related polyneuropathy following laparoscopic sleeve gastrectomy: A case report and literature review.

A 48-year-old man developed severe polyneuropathy due to marked hypocupremia 9 months after laparoscopic sleeve gastrectomy.

• The patient underwent laparoscopic sleeve gastrectomy (SG) for morbid obesity.
• Three months postoperatively, he developed poor oral intake.
• At 7 months postoperatively, he presented with bilateral distal paresthesia and gait disturbance.
• Symptoms transiently improved after vitamin B supplementation but progressively worsened.
• At 9 months postoperatively, he was admitted with severe polyneuropathy and laboratory testing revealed marked hypocupremia.

Intravenous copper supplementation led to substantial neurological improvement in the patient with copper deficiency-related polyneuropathy after SG.

• The patient received intravenous copper supplementation following diagnosis of marked hypocupremia.
• The patient experienced substantial neurological improvement following treatment.
• The patient was eventually discharged with neurological improvement.
• The case demonstrates that timely supplementation improves outcomes.

A literature search identified four reports involving five cases of polyneuropathy due to copper deficiency after sleeve gastrectomy or Roux-en-Y gastric bypass.

• Four reports involving five cases were identified in the literature search.
• Cases involved polyneuropathy due to copper deficiency after either SG or Roux-en-Y gastric bypass (RYGB).
• Incidence rates of neurological complications and copper deficiency following both SG and RYGB were also reviewed.
• The literature review highlights that this complication, while rare, is documented across multiple bariatric procedures.

Sleeve gastrectomy has become the most commonly performed bariatric procedure but can still cause serious neurological complications.

• SG is noted for its favorable weight-loss outcomes and lower complication risks compared to other bariatric procedures.
• Despite its favorable profile, serious neurological complications can still occur following SG.
• Copper deficiency is an underrecognized cause of neurological complications in the postoperative bariatric population.

The authors recommend laboratory evaluation for copper deficiency when postoperative neurological symptoms occur following bariatric surgery and highlight the need for standardized postoperative copper monitoring and dosing guidelines.

• The authors emphasize vigilance regarding the presence of copper deficiency after SG.
• Laboratory evaluation is recommended when postoperative neurological symptoms occur.
• The authors highlight the need for standardized postoperative copper monitoring and dosing guidelines.
• Timely copper supplementation was demonstrated to improve neurological outcomes in this case.