Dry Beriberi With Hypoalbuminemia: Mimicking Wet Beriberi in a Post-Sleeve Gastrectomy Patient

Abstract

Thiamine (vitamin B1) is an essential water-soluble vitamin that plays a critical role in carbohydrate metabolism and neurological function. As it cannot be stored in the body, deficiencies may occur rapidly in individuals with inadequate intake or absorption. Post-gastrectomy patients are particularly vulnerable due to reduced dietary intake, altered digestion, and malabsorption. Thiamine deficiency can lead to dry beriberi with peripheral neuropathy, wet beriberi with cardiovascular compromise, and Wernicke’s encephalopathy. We report the case of a 24-year-old woman who developed progressive neurological symptoms such as distal weakness, sensory loss, and gait instability several months after laparoscopic sleeve gastrectomy. Laboratory investigations revealed markedly reduced thiamine levels, confirming the diagnosis. Prompt intravenous thiamine replacement resulted in gradual neurological improvement. This case underscores the importance of considering micronutrient deficiencies, particularly thiamine, in post-bariatric surgery patients presenting with neurological decline, and highlights the need for routine long-term micronutrient monitoring in this population.