Osteomalacia after Roux-en-Y gastric bypass

Maria L. Collazo-Clavell, Antonio Jimenez, Stephen F. Hodgson, Michael G. Sarr

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Objective: To emphasize the potential for Roux-en-Y gastric bypass treatment of morbid obesity to result in late development of metabolic bone disease and to illustrate the error of treating a low bone mineral density with bisphosphonates in the presence of unrecognized osteomalacia. Methods: We conducted a retrospective case review of clinical, laboratory, and radiologic details in a patient who underwent Roux-en-Y gastric bypass as well as a review of the literature relative to metabolic bone disease associated with bariatric surgical procedures. Results: A 42-year-old woman was diagnosed with high bone turnover osteoporosis and failed to respond to bisphosphonate (alendronate) therapy. Her past medical history included corticosteroid-dependent asthma and a Roux-en-Y gastric bypass surgical procedure for obesity approximately 6 1/2 years before the current assessment. Evaluation revealed vitamin D deficiency in conjunction with pronounced secondary hyperparathyroidism and biochemical evidence of osteomalacia. Aggressive calcium and vitamin D supplementation corrected the vitamin D-deficient state and was accompanied by rapid improvement in clinical symptoms, biochemical variables, and bone mineral density. Conclusion: This case exemplifies two principles: (1) the potential for a Roux-en-Y gastric bypass surgical procedure to lead to the development of metabolic bone disease and (2) the importance of recognizing mineralization defects as a cause for low bone mineral density, before initiation of therapy with bisphosphonates.

Original languageEnglish (US)
Pages (from-to)195-198
Number of pages4
JournalEndocrine Practice
Volume10
Issue number3
StatePublished - May 2004

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Osteomalacia
Gastric Bypass
Metabolic Bone Diseases
Diphosphonates
Bone Density
Vitamin D
Alendronate
Secondary Hyperparathyroidism
Vitamin D Deficiency
Bariatric Surgery
Morbid Obesity
Bone Remodeling
Osteoporosis
Adrenal Cortex Hormones
Therapeutics
Asthma
Obesity
Calcium

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Collazo-Clavell, M. L., Jimenez, A., Hodgson, S. F., & Sarr, M. G. (2004). Osteomalacia after Roux-en-Y gastric bypass. Endocrine Practice, 10(3), 195-198.

Osteomalacia after Roux-en-Y gastric bypass. / Collazo-Clavell, Maria L.; Jimenez, Antonio; Hodgson, Stephen F.; Sarr, Michael G.

In: Endocrine Practice, Vol. 10, No. 3, 05.2004, p. 195-198.

Research output: Contribution to journalArticle

Collazo-Clavell, ML, Jimenez, A, Hodgson, SF & Sarr, MG 2004, 'Osteomalacia after Roux-en-Y gastric bypass', Endocrine Practice, vol. 10, no. 3, pp. 195-198.
Collazo-Clavell ML, Jimenez A, Hodgson SF, Sarr MG. Osteomalacia after Roux-en-Y gastric bypass. Endocrine Practice. 2004 May;10(3):195-198.
Collazo-Clavell, Maria L. ; Jimenez, Antonio ; Hodgson, Stephen F. ; Sarr, Michael G. / Osteomalacia after Roux-en-Y gastric bypass. In: Endocrine Practice. 2004 ; Vol. 10, No. 3. pp. 195-198.
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