• W Mauhin, H Bouzidi, A Colson, G Lejour, Y Miao, C Montagner, J London, B Subran, R Amathieu, T Lazard, and O Lidove.
• Service de médecine interne, groupe hospitalier Diaconesses Croix-Saint-Simon, site Avron, 75020 Paris, France. Electronic address: wmauhin@hopital-dcss.org.
• Rev Med Interne. 2021 Oct 1; 42 (10): 729-733.

IntroductionBariatric surgery is a very effective treatment for obesity. After gastric bypass, micronutrient deficiencies frequently occur which can have dramatic consequences.Case ReportWe report the case of a 55-year-old woman who was admitted for psychomotor retardation, bilateral leg pitting edema and psoriasis-like rash that had been ongoing for 3 months. Pancytopenia, encephalopathy and heart failure rapidly occurred leading to multiorgan dysfunction syndrome and death. We retrospectively identified severe selenium deficiency with possible secondary cardiomyopathy, niacin deficiency resulting in pellagrous encephalopathy with skin lesions and gelatinous transformation of bone marrow.ConclusionMicronutrient deficiency should systematically be assessed when new symptoms occur in a patient with a history of bariatric surgery. Selenium deficiency should be considered in the presence of any heart failure in this context.Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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