Late Presentation of Fatal Hyperammonemic Encephalopathy After Roux-En-Y Gastric Bypass

Nagarur, Amulya; Fenves, Andrew Z.

doi:10.1080/08998280.2017.11929521

Cited by 25 publications

(32 citation statements)

References 7 publications

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“…Third, a catabolic state accelerating protein breakdown may also contribute to hyperammonemia. 1 In our case, hyperammonemia occurred 9 months after the Roux-en-Y surgery;…”

mentioning

confidence: 52%

“…A few cases of symptomatic hyperammonemia after Roux-en-Y surgery have been reported in adults. 1 Salmonella enteritis as a common cause of infectious colitis and acute encephalopathy associated with nontyphoidal salmonellosis has been reported. Here, we introduce a child who suffered from hyperammonemic encephalopathy with Salmonella enteritis after Roux-en-Y surgery.…”

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confidence: 99%

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Hyperammonemic encephalopathy in a pediatric patient with Salmonella enteritis and after Roux‐en‐Y surgery

Chen

Lin

et al. 2019

The Kaohsiung J of Med Scie

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“…Third, a catabolic state accelerating protein breakdown may also contribute to hyperammonemia. 1 In our case, hyperammonemia occurred 9 months after the Roux-en-Y surgery;…”

mentioning

confidence: 52%

mentioning

confidence: 99%

Hyperammonemic encephalopathy in a pediatric patient with Salmonella enteritis and after Roux‐en‐Y surgery

Chen

Lin

et al. 2019

The Kaohsiung J of Med Scie

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“…Bacterial urease is suspected to cause hyperammonemic encephalopathy in absence of liver cirrhosis [44]. Hyperammonemic encephalopathy has been recently described as being a severe complication of LRYGB [46]. After LRYGB, we also observed an increased potential for Trimethylamine oxidized (TMAO) utilization via pathways found in Proteobacteria (torYZ and torC, Supplementary Table 12).…”

Section: Nitrates Respiration May Favour E Coli Expansion After Lrygbmentioning

confidence: 73%

Laparoscopic Roux-en-Y gastric bypass profoundly changes gut microbiota compared to laparoscopic sleeve gastrectomy: a metagenomic comparative analysis

Farin

Fp²,

Plassais

et al. 2018

Preprint

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Affiliations 1. ENTEROME, 94/96 av. Ledru Rollin, Abstract Background: Bariatric surgery is an effective therapeutic procedure for morbidly obese patients as it induces sustained weight loss. The two most common interventions are Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB). Objective: Characterizing the gut microbiota changes induced by LSG and LRYGB. Design: 89 and 108 patients who underwent LSG and LRYGB respectively, were recruited from three countries: USA, France and Switzerland. Stools were collected before and 6 months after surgery. Microbial DNA was analysed with shotgun metagenomic sequencing (SOLiD 5500xl Wildfire). MSPminer, a novel innovative tool to characterize new in silico biological entities, was used to identify 715 Metagenomic Species Pan-genome (MSPs). 148 functional modules were analysed using GOmixer and KEGG database. Results: Both interventions resulted in a similar increase of Shannon's diversity index and gene richness of gut microbiota, in parallel with weight loss, but the changes of microbial composition were different. LRYGB led to higher relative abundance of aero-tolerant bacteria, such as Escherichia coli and buccal species, such as Streptococcus and Veillonella spp. In contrast, anaerobes such as Clostridium were more abundant after LSG, suggesting better conservation of anaerobic conditions in the gut. Function-level changes included higher potential for bacterial use of supplements such as vitamin B12, B1 and iron upon LRYGB. Moreover, after LRYGB, potential for nitrate and Trimethylamine oxidized (TMAO) respiration was detected.Conclusion: Microbiota changes after bariatric surgery depend on the nature of the intervention. LRYGB induces greater taxonomic and functional changes in gut microbiota than LSG and may lead to a more dysbiotic microbiome. Possible long-term health consequences of these alterations remain to be established. Significance of this study What is already known on this subject?Previous studies have reported changes of microbial composition after bariatric surgery with shotgun metagenomics, but lacked statistical power to document the changes. Important shifts in gut microbiome have been observed after LRYGB and LSG with an increase of aerotolerants from buccal microbiota. However, it is not clear how different the changes are between LRYGB and LSG although both procedures induce quite similar results with respect to weight loss, comorbidities remission and global glycaemic improvement outcomes. What are the new findings?LSG and LRYGB have specific but different impacts on gut microbial composition 6 months after bariatric surgery. The changes could be related to specific physiological effects. LRYGB promotes an important invasion of oral colonizers with Veillonella and Streptococcus genera.In contrast, these changes were less important after LSG. Moreover, microbial transportation potential of iron and vitamin B12 were also higher after LRYGB than LSG. We concluded that the type of surgery leads to different gut m...

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“…Определение Описаны случаи постбариатрической гипераммониемической энцефалопатии после хирургического шунтирования желудка Roux-en-Y (RYGB), самой распространенной процедурой снижения веса, проводимой в США [35,36,37,38,]. Высокий риск гипераммонемической энцефалопатии после операции Roux-en-Y, при котором смертность приближается к 50%, установлен у женщин в возрастной группе 34-69 лет, даже не имевших в анамнезе к-л заболевания печени [39][40][41][42][43][44][45][46][47][48][49][50][51][52]. Риск фатального исхода может быть обусловлен и тем фактом, что постбариатрическия гипераммониемия не сопровождается какими-либо изменениями биохимических показателей печеночного метаболизма.…”

Section: положениеunclassified

Russian Consensus “Hyperammonemia in Adults”

Лазебник

Голованова

Алексеенко

et al. 2019

jour

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The human body, like any other, is an intermediate component of the nitrogen cycle in nature. Consuming nitrogen from the external environment in the form of various compounds, the body processes it into ammonia - one of the final products of exchange of nitrogen-containing substances [1], which is removed from the body in the form of urea. The most active ammonia producers are organs with high exchange of amino acids and biogenic amines - nerve tissue, liver, intestine, and muscles. In a state of nitrogen equilibrium, the adult body consumes and releases about 15 g of nitrogen per day, temporary or permanent disruption of nitrogen balance results in a great number of physiological conditions and diseases, and the need to stabilize it is well known. However, despite a huge number of studies on the role of nitrogen metabolism and its compounds in the clinic, to date we have not been able to find any conciliation document in the world literature on the classification of ammonia-ammonium levels in human blood and approaches to the correction of hyperammonemia, which was the basis for the emergence of this consensus.

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Late Presentation of Fatal Hyperammonemic Encephalopathy After Roux-En-Y Gastric Bypass

Cited by 25 publications

References 7 publications

Hyperammonemic encephalopathy in a pediatric patient with Salmonella enteritis and after Roux‐en‐Y surgery

Hyperammonemic encephalopathy in a pediatric patient with Salmonella enteritis and after Roux‐en‐Y surgery

Laparoscopic Roux-en-Y gastric bypass profoundly changes gut microbiota compared to laparoscopic sleeve gastrectomy: a metagenomic comparative analysis

Russian Consensus “Hyperammonemia in Adults”

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