Postgastrectomy polyneuropathy with thiamine deficiency

H. Koike, K. Misu, N. Hattori, Shinji Ito, M. Ichimura, H. Ito, M. Hirayama, M. Nagamatsu, T. Sasaki, G. Sobue

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Objective - Polyneuropathy has been reported after gastrectomy performed to treat various lesions. Although thiamine deficiency is a possible cause of this neuropathy, the pathogenesis still remains to be clarified. Seventeen patients with peripheral neuropathy with thiamine deficiency after gastrectomy are described. Methods - Seventeen patients with polyneuropathy after gastrectomy accompanied by thiamine deficiency were selected. Patients were restricted to those with total or subtotal gastric resection to treat ulcer or neoplasm. Patients who had undergone operations to treat morbid obesity were excluded. Results - Intervals between the operation and onset of neuropathy varied from 2 months to 39 years. Most patients did not seem malnourished. Serum concentrations of B vitamins other than thiamine were nearly normal. Symmetric motor-sensory polyneuropathy, predominantly involving the lower limbs, had progressed over intervals varying from 3 days to 8 years. Relative degrees of motor and sensory impairment also varied extensively. Some cases that progressed rapidly mimicked Guillain-Barré syndrome. Electrophysiological and pathological findings were those of axonal neuropathy. Substantial functional recovery from polyneuropathy was seen in most patients by 3 to 6 months after initiating thiamine supplementation. Motor recovery was better than sensory recovery. Conclusions - Various symptoms were seen in patients with postgastrectomy neuropathy. Thiamine deficiency should be considered in the differential diagnosis of motor-sensory polyneuropathy after gastrectomy.

Original languageEnglish
Pages (from-to)357-362
Number of pages6
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume71
Issue number3
DOIs
Publication statusPublished - 01-09-2001

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Thiamine Deficiency
Polyneuropathies
Gastrectomy
Thiamine
Vitamin B Complex
Morbid Obesity
Peripheral Nervous System Diseases
Ulcer
Lower Extremity
Stomach
Differential Diagnosis
Serum

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Koike, H. ; Misu, K. ; Hattori, N. ; Ito, Shinji ; Ichimura, M. ; Ito, H. ; Hirayama, M. ; Nagamatsu, M. ; Sasaki, T. ; Sobue, G. / Postgastrectomy polyneuropathy with thiamine deficiency. In: Journal of Neurology Neurosurgery and Psychiatry. 2001 ; Vol. 71, No. 3. pp. 357-362.
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Koike, H, Misu, K, Hattori, N, Ito, S, Ichimura, M, Ito, H, Hirayama, M, Nagamatsu, M, Sasaki, T & Sobue, G 2001, 'Postgastrectomy polyneuropathy with thiamine deficiency', Journal of Neurology Neurosurgery and Psychiatry, vol. 71, no. 3, pp. 357-362. https://doi.org/10.1136/jnnp.71.3.357

Postgastrectomy polyneuropathy with thiamine deficiency. / Koike, H.; Misu, K.; Hattori, N.; Ito, Shinji; Ichimura, M.; Ito, H.; Hirayama, M.; Nagamatsu, M.; Sasaki, T.; Sobue, G.

In: Journal of Neurology Neurosurgery and Psychiatry, Vol. 71, No. 3, 01.09.2001, p. 357-362.

Research output: Contribution to journalArticle

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T1 - Postgastrectomy polyneuropathy with thiamine deficiency

AU - Koike, H.

AU - Misu, K.

AU - Hattori, N.

AU - Ito, Shinji

AU - Ichimura, M.

AU - Ito, H.

AU - Hirayama, M.

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AU - Sasaki, T.

AU - Sobue, G.

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N2 - Objective - Polyneuropathy has been reported after gastrectomy performed to treat various lesions. Although thiamine deficiency is a possible cause of this neuropathy, the pathogenesis still remains to be clarified. Seventeen patients with peripheral neuropathy with thiamine deficiency after gastrectomy are described. Methods - Seventeen patients with polyneuropathy after gastrectomy accompanied by thiamine deficiency were selected. Patients were restricted to those with total or subtotal gastric resection to treat ulcer or neoplasm. Patients who had undergone operations to treat morbid obesity were excluded. Results - Intervals between the operation and onset of neuropathy varied from 2 months to 39 years. Most patients did not seem malnourished. Serum concentrations of B vitamins other than thiamine were nearly normal. Symmetric motor-sensory polyneuropathy, predominantly involving the lower limbs, had progressed over intervals varying from 3 days to 8 years. Relative degrees of motor and sensory impairment also varied extensively. Some cases that progressed rapidly mimicked Guillain-Barré syndrome. Electrophysiological and pathological findings were those of axonal neuropathy. Substantial functional recovery from polyneuropathy was seen in most patients by 3 to 6 months after initiating thiamine supplementation. Motor recovery was better than sensory recovery. Conclusions - Various symptoms were seen in patients with postgastrectomy neuropathy. Thiamine deficiency should be considered in the differential diagnosis of motor-sensory polyneuropathy after gastrectomy.

AB - Objective - Polyneuropathy has been reported after gastrectomy performed to treat various lesions. Although thiamine deficiency is a possible cause of this neuropathy, the pathogenesis still remains to be clarified. Seventeen patients with peripheral neuropathy with thiamine deficiency after gastrectomy are described. Methods - Seventeen patients with polyneuropathy after gastrectomy accompanied by thiamine deficiency were selected. Patients were restricted to those with total or subtotal gastric resection to treat ulcer or neoplasm. Patients who had undergone operations to treat morbid obesity were excluded. Results - Intervals between the operation and onset of neuropathy varied from 2 months to 39 years. Most patients did not seem malnourished. Serum concentrations of B vitamins other than thiamine were nearly normal. Symmetric motor-sensory polyneuropathy, predominantly involving the lower limbs, had progressed over intervals varying from 3 days to 8 years. Relative degrees of motor and sensory impairment also varied extensively. Some cases that progressed rapidly mimicked Guillain-Barré syndrome. Electrophysiological and pathological findings were those of axonal neuropathy. Substantial functional recovery from polyneuropathy was seen in most patients by 3 to 6 months after initiating thiamine supplementation. Motor recovery was better than sensory recovery. Conclusions - Various symptoms were seen in patients with postgastrectomy neuropathy. Thiamine deficiency should be considered in the differential diagnosis of motor-sensory polyneuropathy after gastrectomy.

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