Abstract
Long term HPN in adults may alter the severity of Crohn's disease. To assess such therapy, 16 children, ages 9¼ to 19½ years, received an initial course of HPN averaging 140 days. Disease extent was small bowel-l, large bowel-l or both-14. All were symptomatic in spite of therapy with AzulfidineR (14), steroids (11) and/or previous resections (6). All discontinued drugs once HPN was started. One needed subsequent steroids. 8 are in remission from 45 to 508 days after one HPN course. 6 relapsed within 140 days of the initial course. 3 completed a 2nd course averaging 121 days, with 2 relapsing within 90 days and 1 in remission to 204 days. Of the 9 in remission, only 5 are at >5 months. 1, 3 and 2 respectively have completed an initial, 2nd and 3rd course of HPN. 1 required surgery for a rectal fissure after an initial 122 days of HPN. All gained weight (11¼ kg average), had marked clinical improvement and resumed peer group activities while on HPN. 9 demonstrated “catch up” growth and 4 others had appropriate height increases. Enteric protein loss was reduced after HPN in 2 of 7 patients. Both are in remission >5 months. Complications included catheter removal (1 per 432 days) for sepsis (2), dislodgement (2), subcutaneous leak (1), thrombosis (1) and local infection (1). HPN can be safely used in managing children with severe Crohn's disease and may induce a remission, promote weight gain and growth, and improve social well-being
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Strobel, C., Byrne, W., Isenberg, J. et al. 476 HOME PARENTERAL NUTRITION (HPN) IN CHILDREN WITH CROHN'S DISEASE PROMOTES GROWTH AND INDUCES CLINICAL REMISSIONS. Pediatr Res 12 (Suppl 4), 443 (1978). https://doi.org/10.1203/00006450-197804001-00481
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DOI: https://doi.org/10.1203/00006450-197804001-00481