Glucocorticoids Improve Enteral Feeding Tolerance in Pediatric Short Bowel Syndrome With Chronic Intestinal Inflammation
| Autor: | Brandi K. Gerhardt, Samantha J Logan, David F. Mercer, Ruben E. Quiros-Tejeira, Fangfang Wang, Sarah N. Iwansky, Brandy D. Hobson |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Short Bowel Syndrome
Budesonide medicine.medical_specialty Enteral administration Gastroenterology 03 medical and health sciences Enteral Nutrition 0302 clinical medicine 030225 pediatrics Internal medicine Biopsy Humans Medicine Weaning Child Glucocorticoids Retrospective Studies Inflammation medicine.diagnostic_test business.industry Gastroschisis Infant Short bowel syndrome medicine.disease Regimen Treatment Outcome Parenteral nutrition Pediatrics Perinatology and Child Health Female 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Journal of Pediatric Gastroenterology & Nutrition. 73:17-22 |
| ISSN: | 1536-4801 0277-2116 |
| Popis: | OBJECTIVES A group of short bowel syndrome (SBS) patients developed chronic intestinal inflammation while struggling weaning off parenteral nutrition (PN). They did not respond to standard management of SBS and food allergy. We treated them with glucocorticoids and described the outcome. METHODS Our study is a retrospective descriptive study. We reviewed records from the intestinal rehabilitation program from 2006 to 2017. We identified 15 patients whose lab values, pathology results, and clinic notes were reviewed. RESULTS We had more patients (n = 10) with diagnosis of gastroschisis, and more female patients (n = 9). Seven patients weaned off PN with median treatment duration of 5 months, 5 of which remained on budesonide for significant period of time (median: 7.5 months). One of these 7 patients relapsed, as the patient resumed glucocorticoids because of recurrence of chronic intestinal inflammation. Six of 15 children had significant eosinophils in their initial biopsy, 5 of these children weaned off PN whereas 1 child's gastrointestinal (GI) bleeding stopped. Four patients were not able to decrease PN calorie. Two of these patients' GI bleeding stopped, the other 2 had normalized histology. CONCLUSIONS For SBS children with histologically confirmed chronic intestinal inflammation, glucocorticoids may help promote enteral feeding tolerance. Glucocorticoids regimen should be chosen individually. Patients are more likely to respond if initial histology has significant eosinophilic infiltration. Patients may need to remain on glucocorticoids for over 6 months. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text