PMID: 109347Aug 1, 1979

Home parenteral nutrition in children with Crohn's disease: an effective management alternative

Gastroenterology
C T StrobelM E Ament

Abstract

Seventeen pediatric patients, ages 9.25--20.5 yr, were placed on a program of home parenteral nutrition (HPN) for severe, symptomatic Crohn's disease. Prior therapy with sulfasalazine in 14, adrenocorticosteroids in 12, inpatient total parenteral nutrition in 7, and/or surgical resections in 6 failed to suppress disease activity. Remission was attained in 12 of the 17 after one course of HPN alone. Four patients had surgical procedures and 1 required steroids in addition to HPN. Remissions have been maintained in 4 of those 12 for a mean duration of 315 days after discontinuation of HPN. Of the 8 who relapsed after a mean duration of 68 days, second courses of HPN were undertaken in 7 and third courses in 2. All 17 had a marked improvement in disease symptoms while receiving HPN in addition to gaining weight sufficient to place them at a higher percentile on standard growth charts. Ten patients demonstrated "catch-up" growth and 4 others increased their height appropriately. A chromium 51-labeled albumin stool collection of greater than 1% in 5 of 7 patients at the completion of a HPN course correlated with relapse within 4 mo. Serial radiographic contrast studies and erythrocyte sedimentation rates were not predictive of prolo...Continue Reading

Citations

Feb 1, 1996·Pediatric Clinics of North America·B S Kirschner
Jul 1, 1992·Baillière's Clinical Endocrinology and Metabolism·E Mayer, M Stern
Aug 1, 2008·Nutrition Reviews·Denish MoorthyIrwin H Rosenberg
Jan 1, 1983·Archives of Disease in Childhood·C O'MoráinH B Valman
Feb 1, 1984·Gut·I W Booth, J T Harries
Jun 6, 2009·World Journal of Gastroenterology : WJG·Corina HartmanRaanan Shamir

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