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Journal of Obesity
Volume 2011, Article ID 141024, 3 pages
http://dx.doi.org/10.1155/2011/141024
Case Report

Severe Hypocalcemia due to Vitamin D Deficiency after Extended Roux-en-Y Gastric Bypass

1Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, S. Antoni M. Claret 167, 08025 Barcelona, Spain
2CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital de la Santa Creu i Sant Pau, S. Antoni M. Claret 167, 08025 Barcelona, Spain

Received 18 February 2011; Accepted 23 March 2011

Academic Editor: Francesco Saverio Papadia

Copyright © 2011 I. Miñambres et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Vitamin D deficiency is a well-known comorbidity of obesity that can be exacerbated after bariatric surgery and can predispose the patient for hypocalcemia. Vitamin D and calcium doses to prevent and treat vitamin D deficiency after weight loss surgery are not well defined. We describe a patient who developed severe hypocalcemia due to vitamin D deficiency 5 years after an extended Roux-en-Y gastric bypass for a type II obesity. No precipitating factors were present and malabsorption induced by the bypass was considered to be the main causative factor. High doses of vitamin D and calcium were needed to reach and maintain normal calcium and vitamin D concentrations. This case emphasises the importance of routine screening for vitamin D deficiency in obese individuals and reflects that while consensus does not exist regarding optimal dosage, vitamin D replacement should be tittered based on calcidiol levels.