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Bone disease after jejuno-ileal bypass for morbid obesity.
  1. I. T. Gilmore,
  2. J. B. Eastwood,
  3. W. R. Ellis,
  4. V. A. Luck,
  5. S. Fenton,
  6. A. J. O'Grady,
  7. E. Harris,
  8. I. M. Murray-Lyon


    Fifteen patients who had undergone a 14 inches X 4 inches jejuno-ileal bypass operation for obesity, 3 to 4 years earlier, were investigated by iliac bone biopsy, radiology and routine biochemistry, including 25-hydroxy-vitamin D and parathyroid hormone estimations. Two patients had histological osteomalacia which was mild in one. A further 9 patients had abnormal bone biopsies, there being an excess of trabecular bone surface covered by osteoid with a normal or reduced amount of calcification front. Six of these 9 showed an increase in trabecular resorption, although in none were there excessive numbers of osteoclasts. The likely explanation for these findings is that these 9 patients had early osteomalacia with mild hyperparathyroidism, making a total of 11 patients out of 15 with osteomalacia. Radiology and blood chemistry were poor predictors of histological bone disease.

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