ABSTRACT
Introducción: La enteropatía en penacho, conocida como displasia epitelial intestinal, es una afección congénita muy poco frecuente que se presenta con diarrea refractaria en lactantes. Objetivo: Describir el primer reporte en Cuba de enteropatía congénita en penachos. Presentación del caso: Se presentó el primer caso de la enfermedad en Cuba a partir de los hallazgos histopatológicos y se describieron los aspectos clínicos, diagnósticos y terapéuticos abordados. Conclusiones: La enteropatía en penachos supone un reto diagnóstico al no exhibir un cortejo clínico patognomónico. La concomitancia de diarrea crónica con los trastornos malformativos debe hacer saltar las alarmas y orientar el pensamiento clínico y la metodología diagnóstica hacia posibles trastornos genéticos(AU)
Introduction: Tufting enteropathy, also known as intestinal epithelial dysplasia, is a very infrequent congenital disorder presenting as refractory diarrhea in infants. Objective: Describe the first report of congenital tufting enteropathy in Cuba. Case presentation: A presentation is provided of the first case of the disease in Cuba based on histopathological findings and accompanied by a description of the clinical, diagnostic and therapeutic aspects addressed. Conclusions: Tufted enteropathy poses a diagnostic challenge as it does not exhibit a pathognomonic clinical courtship. The concomitance of chronic diarrhea with malformation disorders should set off alarms and guide clinical thinking and diagnostic methodology towards possible genetic disorders(AU)
Subject(s)
Humans , Infant , Diarrhea, Infantile/complications , Intestinal Diseases/congenital , CubaABSTRACT
OBJECTIVE: To investigate the therapeutic effect of fecal microbiota transplantation(FMT) combined with enteral nutrition on patients with refractory diarrhea and severe malnutrition.METHODS: Seventy-one patients with refractory diarrhea complicated with severe malnutrition in Department of Colorectal Disease,the Tenth People ' s Hospital of Tongji University and Department of General Surgery,General Hospital of Eastern Theater Command from June 2014 to October 2018 were prospectively collected for basic information,symptoms and signs,number of bowel movements,Bristol stool scores,and nutritional indicators,which were followed up after bacterial transplantation combined with enteral nutrition.RESULTS: After following up for 6 month,FMT combined with enteral nutrition in the treatment of severe diarrhea with severe malnutrition,the effective rate of treatment of diarrhea was 95.8%,of which the cure rate was 74.7%,and the remission rate was 21.1%.3 cases(4.2%) were ineffective,6 cases(8.5%) recurred.The frequency of bowel movements decreased from(8.3±2.2) before treatment to(5.3±1.3) after 1 month,(3.2±0.8)after 3 months,and(1.9±0.6) after 6 months.The Bristol score was reduced from(6.6±0.3) points before treatment to(4.8±0.7) points 1 month after treatment,(4.6±0.8)points after 3 months,and(4.3±0.8) points after 6 months.The body mass index(BMI) of the patients before treatment was 15.3±1.3,the BMI increased to 17.4±2.4 after 1 month of treatment,increased to 19.0±3.2 after 3 months,and 19.3±3.8 after 6 months.The total protein was increased from(48.6±4.7)g/L before treatment to(55.4±5.7)g/L after1 month of treatment,increased to(60.3±5.4) g/L after 3 months,and(68.4±6.9)g after 6 months.Albumin increased from(22.4±1.7)g/L before treatment to(31.7±2.4)g/L after 1 month of treatment,increased to(35.8±2.7)g/L after 3 months,and(37.5±3.7)g/L after 6 months.Fibrinogen increased from(1.6±0.4)g/L before treatment to(2.0±0.7)g/L after 1 month of treatment,increased to(2.4±0.8) g/L after 3 months,and(2.4±0.7) g/L after 6 months.Prealbumin increased from(82.0±18.6)mg/L before treatment to(178.3±25.3)mg/L after 1 month of treatment,increased to(235.7±28.2) mg/L after 3 months,and(259.6±33.5) mg/L after 6 months.The were significant differences before and after treatment(All P<0.05) CONCLUSION: After 6 months of follow-up,FMT combined with enteral nutrition can effectively reduce the number of diarrhea,improve stool characteristics,and improve nutritional indicators such as BMI,total protein,albumin,fibrinogen and prealbumin.