Non-syndromic bile duct paucity and non-IgE cow's milk allergy: a case report of challenging nutritional management and maltodextrin intolerance

Autor:	Degrassi, I., Pascuzzi, M.C., D'Auria, E., Fiori, L., Dilillo, D., Lista, G., Castoldi, F.M., Cavigioli, F., Bosetti, A., Pellegrinelli, A., Zuccotti, G.V., Verduci, E.
Rok vydání:	2022
Předmět:	Settore MED/38 - Pediatria Generale e Specialistica Male Cholestasis Premature infants Bile duct paucity Hypoglycaemia Maltodextrin Infant Newborn Polysaccharides Animals Humans Cattle Female Bile Ducts Milk Hypersensitivity Amino Acids Branched-Chain Triglycerides
Zdroj:	Italian journal of pediatrics. 48(1)
ISSN:	1824-7288
Popis:	Cholestasis in extremely premature infants (EPI) constitutes a nutritional challenge and maltodextrins have been reported as a possible strategy for hypoglycaemia. We aim to describe the nutritional management of an EPI with non-syndromic bile duct paucity (NSBDP) and feeding intolerance.A patient, born at 27 weeks of gestational age, presented cholestatic jaundice at 20 days of life with a clinical picture of NSBDP. Patient's growth was insufficient with formula rich in medium-chain triglyceride (MCT) and branched-chain amino acids (BCAA). Due to frequent fasting hypoglicemic episodes, maltodextrins supplements were provided. He subsequently presented severe abdominal distension and painful crises, which required hospital admission and withdrawal of maltodextrins. Hypercaloric extensively hydrolysed formula provided weight gain, glycemic control, and parallel improvement in cholestasis.Our case suggests caution with the use of maltodextrins in infants, especially if premature. Commercial preparations for hepatopatic patients contain higher concentrations of MCTs and BCAAs, but personalized strategies must be tailored to each patient.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::4a4748f71b40fac5a035b8c212aa7f93 https://pubmed.ncbi.nlm.nih.gov/36109763 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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