# Chronic Guillain-Barré syndrome and refractory diarrhea after RYGB: a 9-year longitudinal case report

## TL;DR

A man developed chronic neurological issues and severe diarrhea after weight-loss surgery, likely due to long-term nutrient deficiencies.

## Contribution

This case suggests a link between long-term micronutrient deficiencies and chronic autoimmune neurological disorders after bariatric surgery.

## Key findings

- The patient experienced progressive neurological deterioration and significant weight loss over 9 years.
- Severe deficiencies in vitamin D, calcium, iron, and other nutrients were observed.
- Autoimmune dysregulation and gastrointestinal dysfunction led to the need for partial parenteral nutrition.

## Abstract

We present a 46-year-old male who developed chronic Guillain-Barré syndrome and refractory diarrhea after undergoing Roux-en-Y gastric bypass, with progressive neurological deterioration and 34.9% total weight loss over 9 years. Serial evaluations demonstrated severe deficiencies include vitamin D, calcium, iron and other nutritions, accompanied by evidence of autoimmune dysregulation. The patient’s condition progressed to require partial parenteral nutrition due to worsening neurological and gastrointestinal dysfunction. This case highlights the critical need for ongoing nutritional monitoring after bariatric surgery and suggests that persistent micronutrient deficiencies may contribute to sustained immune dysfunction, potentially triggering chronic autoimmune neurological disorders in susceptible individuals.