Open AccessEnteral nutrition for severe malnutrition Crohn's disease patient
Author(s) -
Xuemei Li,
Qian You,
Yang Song,
Lei Shi,
Wen Hu
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000020112
Subject(s) - medicine , malnutrition , parenteral nutrition , weight loss , crohn's disease , enteral administration , disease , infliximab , pediatrics , intensive care medicine , surgery , obesity
Crohn's disease (CD) is a chronic systemic inflammatory disease with indefinite remission and relapse cycles, which can result in a high incidence rate of malnutrition. There has been increasing clinical interest in enteral nutrition (EN) as an adjunct treatment for CD. This report aims to present a case of a severely malnourished CD patient given EN support in combination with conventional infliximab (IFX) treatment. Patient concerns: A 42-year-old CD patient with severe malnutrition. She once weighted 27.5 kg (BMI 11.4 kg/m 2 ) with hyponatremia, which may cause sudden death at any time. Diagnosis: In this study, the diagnosis of CD made by our gastroenterologist was based on integrating patient symptoms, radiologic findings, and biopsy results. The patient had no differential diagnosis. Interventions: The patient received EN support and actively followed up for more than 2 years. The patient also received IFX treatment and four surgeries on an as-needed basis to manage her symptoms. Outcomes: The patient's inflammation and symptoms were finally improved by a combination of enteral nutrition and IFX, and her body weight increased to 44 kg. Conclusion: The jejunal feeding tube was the starting point of her weight gain and inflammation reduction, which allowed her adequate energy. EN may be a potential complementary therapeutic strategy to manage clinical symptoms of CD and improve severe malnutrition.