Premium
Omega‐3–Enriched Lipid Emulsion for Liver Salvage in Parenteral Nutrition–Induced Cholestasis in the Adult Patient
Author(s) -
Jurewitsch Brian,
Gardiner Geoffrey,
Naccarato Mark,
Jeejeebhoy Khursheed N.
Publication year - 2011
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607110382023
Subject(s) - cholestasis , parenteral nutrition , liver biopsy , medicine , gastroenterology , regimen , sepsis , liver disease , lipid emulsion , biopsy
The intrahepatic cholestasis attributed to parenteral nutrition (PN) in the adult patient is relatively rare and usually occurs in patients receiving long‐term PN. This article reports the first case of an adult patient with cholestatic PN‐associated liver disease without sepsis who received almost all her nutrition requirements through PN. Administration of an ω‐3–enriched lipid emulsion added to the PN regimen reversed cholestasis and demonstrated histologic improvement on serial liver biopsy. The patient had failed to respond to other modalities of treatment for this condition and was deeply jaundiced. Liver biochemistry profiles returned to baseline, and follow‐up liver biopsy showed that cholestasis had resolved and that the only residual changes were mild portal inflammation with no histochemical or ultrastructural progression. The PN regimen for the patient was restored to provide total estimated energy requirements and remains the principle source of the patient's nutrition to date.