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Total parenteral nutrition treatment efficacy in adolescent eating disorders
Author(s) -
Tamura Akira,
Minami Koichi,
Tsuda Yuuko,
Yoshikawa Norishige
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12717
Subject(s) - medicine , appetite , parenteral nutrition , weight gain , alkaline phosphatase , hormone , gastroenterology , malnutrition , follicle stimulating hormone , growth hormone treatment , weight loss , luteinizing hormone , pediatrics , endocrinology , growth hormone , body weight , obesity , biochemistry , chemistry , enzyme
Background Management of adolescent patients with severe eating disorders who refuse treatment for weight loss is complicated. Nutritional rehabilitation is most important during the growth period; thus, strong support in the form of total parenteral nutrition (TPN) as soon as possible is necessary in severe cases. No studies involving detailed, long‐term follow up have evaluated biochemical markers and gonadotropin in patients undergoing TPN treatment. Methods Twenty‐five adolescent female patients admitted to hospital received TPN immediately, and biochemical marker and gonadotropin levels were measured and analyzed. If subsequent weight gain was observed, TPN treatment was gradually reduced and stopped. Results No patients dropped out of the study. A significant increase in weight was observed during hospitalization (average, 8.0 kg). Under this treatment, serum total bilirubin was significantly decreased at 3 months, total cholesterol was significantly decreased at 2 months, and alkaline phosphatase (ALP) was significantly increased at 3 and 6 months. Follicle‐stimulating hormone response significantly preceded both luteinizing hormone response and appetite recovery. After this treatment, nine of the 25 patients were readmitted for recurrence of appetite loss. Two patients required additional TPN treatment, but seven immediately recovered their appetite after hospitalization without TPN treatment. Bodyweight gain per day was significantly lower and ALP on admission was significantly higher in patients with than without recurrence. Conclusions Most patients had a remarkable recovery of appetite without refusal behaviors and without evidence of malnutrition after admission. Nutrition maintenance with TPN support is particularly important during the growth period.