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Forum Name: Rheumatology Topics

Question: IgA defiency and bariatric surgery


 jlouks - Thu Nov 06, 2008 5:28 pm

Hi There.
I am a 32 year old mother of four, I was diagnosed with an IgA deficiency by my rheumatolgist when I complained of hand stiffness three years ago. I am also morbidly obese, I have researched the various bariatric proceedures and decided RNY is right for me. I had my consult with my surgeon, had approval from cardiologist, and psycologist as required by insuance. I was literally one day before my proceedure when the rheumatologist decided that I should not have this procedure it was to risky given my IgA deficency. No other explaination. I am currently waiting for a second opinion but my appointment is months away so I thought I would ask my question on the board, to see your thoughts on if a patient with no symptoms, diagnosed with an IgA deficency can safely proceed with RNY surgery.
 Debbie Miller, RN - Fri Nov 07, 2008 10:40 am

User avatar Hello,
Of course there are risks involved but as you know, morbid obesity has known, serious risks associated. If you do not take care of this problem, you are likely to have much more risk of premature death as well as diabetes, hypertension, joint problems, other endocrine disorders and a myriad of other problems. In all procedures you must weigh the risks and benefits. I doubt this risk is greater than the risk of NOT getting this life-saving procedure but you should discuss it with your RNY surgeon. You already have the opinion of the rheumatologist. With all the facts out, you will need to decide what is right for you. Your surgeon should be well-versed in the risks associated with the surgeon and with proper follow-up you may be able to counter any ill-effects from the IgA insufficiency. I don't know a lot about this but if ulcers are of concern there is the evidence that the small pouch is less likely to produce ulcer-forming acids and when ulcer does occur it may be treated with medication.

You definitely face risks whether you go ahead with the procedure or not. You need to feel good about which risk is the greater; which is the lesser. You might benefit from some online support through a bariatric specialty such as www.bariatricsupportcenter.com - these folks have been in the business for a very long time and can help you understand the long-term implications and the importance of follow-up care and dietary restrictions, exercise, education, support, etc. for your success.

Good luck.
 jlouks - Mon Nov 10, 2008 11:39 am

I have looked into all risks and I still think that the proceedure is right for me, I have to however get a second opinion from a rheumatologist before my insurance funding will be reinstate for the proceedure.

I was hoping that a rheumatologist on this site would provide their opinion or thoughts, I am new to this site and am not sure how it works. I do however appreciate your feedback, thank you.

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