ABSTRACT
El raquitismo afecta la diferenciación y mineralización del cartílago de crecimiento como consecuencia, en última instancia, de una alteración en los niveles de fósforo y/o calcio. El secundario a la deficiencia de vitamina D es la forma más frecuente (raquitismo carencial). Las manifestaciones clínicas durante los primeros años de vida suelen comprometer en forma más marcada las epífisis de los huesos.Se describe el caso de un lactante de 8 meses con diagnóstico de alergia a la proteína de la leche de vaca que presentó múltiples fracturas patológicas mientras se encontraba bajo tratamiento con fórmulas lácteas a base de aminoácidos. Se efectuó el diagnóstico de raquitismo hipofosfatémico por deficiencia de fósforo y, tras 3 meses de tratamiento con sales de fosfato, calcio, calcitriol, el abandono paulatino de la leche elemental y el descenso gradual de la medicación antiácida, el paciente evolucionó con curación clínico-radiológica del cuadro
The rickets is a disease that affects the differentiation and mineralization of the growth cartilage, as an ultimate consequence of a balance loss in calcium and phosphate levels. Vitamin D deficiency is the most common cause of the rickets (nutritional rickets). Its clinical manifestation during the first years of life involves long bones epiphysis in a more severe way.We report an 8-month-old infant who was diagnosed with cow Ìs milk protein allergy and suffered from multiple fractures while receiving elemental formula as part of his treatment. The final etiology was hypophosphatemic rickets secondary to phosphate deficiency, and after 3 months of phosphate, calcium and calcitriol supplementation, in addition to the gradually reduction of the proportion of elemental formula intake and the decline of the antacid doses, clinical and radiological heal was achieved.
Subject(s)
Humans , Male , Infant , Rickets, Hypophosphatemic/diagnostic imaging , Vitamin D Deficiency , Milk Hypersensitivity , Infant Formula , Rickets, Hypophosphatemic/therapy , Amino AcidsABSTRACT
PURPOSE: Crohn disease (CD) in children is frequently complicated by malnutrition and growth retardation. Conventional treatment with corticosteroid may also affect the growth of children, which may be alleviated by nutritional therapy. Therefore, we performed this study to evaluate the role of nutritional therapy in the treatment of CD in children. METHODS: The study cohort consisted of thirty children under the age of 17 years, admitted to the Asan Medical Center from 2001 to 2005. While 11 children received nutritional therapy (NT) with an elemental diet, 19 received conventional corticosteroid therapy (ST). Comparative analysis was performed for the rate of the induction of remission, recurrence, disease activity index of pre and post-treatment, and changes of the growth using mean standard deviation score for weight (zW) and height (zH). RESULTS: Ten of 11 children with NT and 18 of 19 children with ST completed the therapy. Two of them were lost to follow-up during the treatment. All 10 children with NT and 15 of 18 children with ST achieved remission. While there was no recurrence in children with NT, 7 with ST showed recurrence within 1 year. Pre- and post treatment Pediatric Crohn disease Activity Index (PCDAI) did not show a difference between the two groups. There were no differences in zW and zH between the two groups after 1 year of follow-up. CONCLUSION: This study showed that nutritional therapy could be considered instead of steroid therapy for treatment of children with CD. However, a long-term study will be needed to determine the long-term efficacy.
Subject(s)
Child , Humans , Cohort Studies , Crohn Disease , Follow-Up Studies , Food, Formulated , Lost to Follow-Up , Malnutrition , Recurrence , Remission InductionABSTRACT
An elemental diet, commercially named Elementalio, contains an amino acid mixture and many other essential nutrients. The amino acid mixture is prepared from hydrolysis of swine blood and supplemented with certain crystalline L-amino acid. The animal experiments suggest that it has a better nutritional effect than other domestic elemental diets in terms of body weight gain, nitrogen balance and correction of hypoproteinemia.
ABSTRACT
In the present study, an amino acid mixture had been prepared from whole swine blood by acid hydrolysis, ion-exchange separation and adequate supplementation of L-Trp, L-Met, and L-Ile. The content of essential amino acid, chemical score and essential amino acid index of the product were 49.33, 63.77, and 92.38% respectively and its essential amino acid pattern was closely similar to casein or whole egg protein with sulfur-containing amino acid as its first limiting amino acid. In the rat growth experiment, its nutritional value had been proved to be comparable with casein and better than swine blood powder itself in terms of weight gain, PER, and NPR. Therefore, this amino acid mixture can be considered as an ideal food additive and nitrogen source for elemental diet and this is an important way in the utilization of swine blood.