Tratamiento con nutrición enteral exclusiva (NEE) en paciente pediátrico diagnosticado de enfermedad de Crohn

Abstract

A male, 14 years and 11 month-old patient who is admitted into hospital for suspected inflammatory bowel disease. He has anaemia, recurrent aphthqe of two months’ evolution, occasional diarrhoea and weight loss. The patient has no previous family or personal history of interest of the current process. Anthropometry and additional tests: the patient has an initial weight of 56.9 Kg, a height of 177 cm and a BMI of 18.1. In the analysis, a discreet anaemia is observed (Hb: 10.7 mg/dl), iron deficiency (Fe 13 μg/dl) and an increase in the inflammatory markers (ESR 37 mm, CRP 48.2 mg/dl). Calorimetry: 11.2% fat, 6.4 kg fat mass, 50.5 kg lean mass. Resting metabolic rate (kcal/day) 1373. Densitometry: The bone density of the lumbar spine L2–L4 is considered normal. Fibrocolonoscopy and ileoscopy with biopsy with alterations. The small bowel follow-through was normal. After the additional tests are carried out, the patient is diagnosed with Crohn's disease. Treatment: is begun with azathioprine 150 mg/dl (2.6 mg/kg) in parallel with exclusive enteral nutrition: Modulen IBD Volume/day: 2800 ml, 3360 kcal/day. Clinical progress: From the beginning, the patient tolerates the medication and the exclusive enteral nutrition well. After treatment with Modulen IBD^® for 5 weeks, the outbreak of activity remits (in a short time, a significant improvement in analytical parameters and in the nutritional condition, so, after the 6 weeks, a normal diet for his age is begun. Recovery of weight loss. He now maintains a weight of 62.2 kg (+5.3 kg in 6 weeks).