{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:46:43Z","timestamp":1782402403747,"version":"3.54.5"},"reference-count":49,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Roux\u2010en\u2010Y gastric bypass (RYGB) surgery is a highly effective technique for treating obesity. However, it may result in nutritional deficiencies. Here we report the case of a 55\u2010year\u2010old woman presenting with chronic diarrhea lasting 2 years, accompanied by lower limb paresthesia, macrocytic anemia, leukopenia, and thrombocytopenia. Her medical history included hypothyroidism treated with levothyroxine, and RYGB surgery performed in 2014, with intermittent micronutrient supplementation. The patient developed copper and zinc deficiencies. To our knowledge, this is the first report of a patient presenting with both deficiencies simultaneously with pancytopenia 10 years after RYGB. This case underscores the need to verify adherence to existing preoperative screening recommendations involving preoperative micronutrient measurements to assess micronutrient deficiency risks and multidisciplinary postoperative follow\u2010up,\u00a0the importance of monitoring micronutrient levels, close follow\u2010up of both symptomatic and asymptomatic patients and evaluating adherence to supplementation regimens.<\/jats:p>","DOI":"10.1002\/ncp.70145","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:56:03Z","timestamp":1782399363000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late\u2010onset copper and zinc deficiency following Roux\u2010en\u2010Y gastric bypass (RYGB): A case report and review of the literature"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4694-021X","authenticated-orcid":false,"given":"Jos\u00e9 Juan","family":"Flores\u2010Pati\u00f1o","sequence":"first","affiliation":[{"name":"Escuela de Medicina Universidad de Celaya Celaya Guanajuato Mexico"},{"name":"Department of Internal Medicine Hospital M\u00e9dica Sur Mexico City Mexico"},{"name":"Department of Immunology and Rheumatology Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2375-5836","authenticated-orcid":false,"given":"Claudia","family":"Maya\u2010Salazar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hospital M\u00e9dica Sur Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6224-5180","authenticated-orcid":false,"given":"Ren\u00e9 Daniel","family":"Vera\u2010Ibarra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hospital M\u00e9dica Sur Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1989-8778","authenticated-orcid":false,"given":"Karina","family":"Hern\u00e1ndez\u2010Ayala","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hospital M\u00e9dica Sur Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-3005","authenticated-orcid":false,"given":"Jos\u00e9 A.","family":"Ar\u00edzaga\u2010Berber","sequence":"additional","affiliation":[{"name":"Hospital Star M\u00e9dica San Luis Potos\u00ed San Luis Potos\u00ed Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0201-0045","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Gast\u00e9lum\u2010Cano","sequence":"additional","affiliation":[{"name":"Departamento de Ciencias Qu\u00edmico Biol\u00f3gicas Universidad de Sonora Hermosillo Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2168-9460","authenticated-orcid":false,"given":"Diego","family":"Delgado\u2010Zald\u00edvar","sequence":"additional","affiliation":[{"name":"Department of Immunology and Rheumatology Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Gil\u2010Lopez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-705X","authenticated-orcid":false,"given":"Carlos","family":"Torruco\u2010Sotelo","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine and Clinical Nutrition Hospital M\u00e9dica Sur Mexico City Mexico"},{"name":"Department of Intensive Care Medicine Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.surg.2025.109934","article-title":"Weighing the impact of bariatric surgery: A meta\u2010analysis of long\u2010term outcomes of Roux\u2010en\u2010Y gastric bypass and sleeve gastrectomy","volume":"190","author":"Cunningham MH","year":"2026","journal-title":"Surgery"},{"issue":"7","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"4946","DOI":"10.1007\/s00464-021-08850-y","article-title":"Ten year comparative analysis of sleeve gastrectomy, Roux\u2010en\u2010Y gastric bypass, and biliopancreatic diversion with duodenal switch in patients with BMI \u2265 50 kg\/m2","volume":"36","author":"Maroun J","year":"2022","journal-title":"Surg 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