SciELO - Scientific Electronic Library Online

vol.36 issue1Spanish Home Enteral Nutrition Registry of the year 2016 and 2017 from the NADYA-SENPE Group author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Nutrición Hospitalaria

On-line version ISSN 1699-5198Print version ISSN 0212-1611


ZUBIAGA, Lorea et al. Whipple disease after bariatric surgery: from malabsorption to malnutrition status. Nutr. Hosp. [online]. 2019, vol.36, n.1, pp.238-241.  Epub Apr 26, 2021. ISSN 1699-5198.

Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions.

We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy.

Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications.

Keywords : Whipple disease; One anastomosis gastric bypass; Malabsorption; Malnutrition; Protein-losing enteropathy.

        · abstract in Spanish     · text in English     · English ( pdf )