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Revista mexicana de pediatría

Print version ISSN 0035-0052

Abstract

ANAYA-FLOREZ, María Salomé; BARBOSA-CORTES, María de Lourdes  and  BARRAZA TINAJERO, Alfa. Ultra-short bowel syndrome and metabolic bone disease in a patient on total parenteral nutrition. Rev. mex. pediatr. [online]. 2023, vol.90, n.1, pp.22-26.  Epub Feb 26, 2024. ISSN 0035-0052.  https://doi.org/10.35366/112595.

Introduction:

pediatric short bowel syndrome (SBS) patients receiving prolonged total parenteral nutrition (TPN) may develop bone mineral disease by different mechanisms.

Case report:

16-year-old female adolescent who has received TPN support for more than a year, after resection of both an abdominal tumor and a large portion of intestine, for which the residual intestine was 5 cm of jejunum, without valve ileocecal or ascending colon and half of transverse colon. Six months after TPN, she presented vitamin D deficiency (12.9 ng/mL), so the dose was increased to 400 IU in TPN. After five months, vitamin D values remained low (21.9 ng/dL), for which cholecalciferol was added, reaching normal levels. During this period, it was found that bone mineral density was low, but it improved with vitamin D supplementation.

Conclusions:

the data from this clinical case indicate the need to monitoring of bone health in patients with SBS dependent on prolonged TPN.

Keywords : ultra-short bowel syndrome; total parenteral nutrition; metabolic bone disease; 25-hydroxyvitamin D.

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