Huerta Sergio, Rogers Lisa M, Li Zhaoping, Heber David, Liu Carson, Livingston Edward H
UCLA Center for Human Nutrition, Los Angeles 90095-1742, USA.
Am J Clin Nutr. 2002 Aug;76(2):426-9. doi: 10.1093/ajcn/76.2.426.
Biliopancreatic diversion (BPD) has been advocated for the treatment of morbid obesity. This procedure has the theoretical advantage that patients retain normal eating capacity and lose weight irrespective of their eating habits. However, vitamin deficiencies may develop because BPD causes malabsorption.
This report describes a 40-y-old mother and her newborn infant, who developed vitamin A deficiency as a result of iatrogenic maternal malabsorption after BPD. Our primary objective is to show that BPD patients need close follow-up and lifelong micronutrient supplementation to prevent nutrient deficiencies in themselves and their offspring.
The medical records of the mother and infant were reviewed, and their clinical course was followed until 10 mo postpartum. The mother was also interviewed on several occasions about her medical care, follow-up, and supplemental vitamin use.
The mother developed night blindness with undetectable serum vitamin A concentrations in the third trimester of her pregnancy. Her vitamin A deficiency was untreated until she delivered her infant. At delivery, the infant also had vitamin A deficiency. He may have permanent retinal damage, but this is still unclear because the ophthalmologic examination performed at 2 mo of age was inconclusive.
Complications of BPD may take many years to develop, and the signs and symptoms may be subtle. Because of the malabsorption that results from BPD, patients need lifelong follow-up and appropriate vitamin supplementation to prevent deficiencies. These nutrient deficiencies can also affect the offspring of female BPD patients.
胆胰转流术（BPD）已被提倡用于治疗病态肥胖。该手术具有理论优势，即患者无论饮食习惯如何，都能保持正常的进食能力并减轻体重。然而，由于BPD导致吸收不良，可能会出现维生素缺乏症。
本报告描述了一名40岁的母亲及其新生儿，该母亲因BPD术后医源性母体吸收不良而出现维生素A缺乏症。我们的主要目的是表明BPD患者需要密切随访和终身补充微量营养素，以预防自身及其后代的营养缺乏。
回顾了母亲和婴儿的病历，并对他们的临床病程进行随访直至产后10个月。还多次就母亲的医疗护理、随访和补充维生素的使用情况对她进行了访谈。
母亲在妊娠晚期出现夜盲症，血清维生素A浓度检测不到。直到她分娩婴儿时，她的维生素A缺乏症都未得到治疗。分娩时，婴儿也患有维生素A缺乏症。他可能有永久性视网膜损伤，但由于2个月大时进行的眼科检查结果不明确，目前尚不清楚。
BPD的并发症可能需要数年时间才会出现，其体征和症状可能很细微。由于BPD导致吸收不良，患者需要终身随访和适当补充维生素以预防缺乏症。这些营养缺乏症也会影响女性BPD患者的后代。
