Brief clinical report: glutamine-enriched total parenteral nutrition in a patient with radiation-induced renal and intestinal fibrosis.
This brief clinical report illustrates the case of a 50-y-old male patient with severe radiation-induced renal and intestinal fibrosis who received glutamine-enriched total parenteral nutrition (TPN). The patient had end-stage renal disease and, therefore, underwent a kidney transplant. In the postoperative course the patient developed signs of bowel obstruction and cachexia. He received two courses of glutamine-enriched TPN before he underwent surgery for small bowel stenosis. Postoperatively, the patient received a third course of glutamine-enriched TPN. During the patient's hospital course the following indexes were monitored: patient's weight, serum concentrations of protein, albumin, and trialglycerol. Intestinal permeability was assessed with the lactulose-mannitol sugar test (L-M test). We measured changes in the patient's weight and the L-M test. We hypothesize that glutamine-enriched TPN may have been beneficial in the hospital course of this critically ill patient and may have influenced the patient's intestinal function and permeability.
Wicke
C
C
Department of General Surgery, University of Tübingen, Germany.
Gottwald
T
T
Becker
H D
HD
D005355:Fibrosis; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D007422:Intestines / Q000473:pathology* / Q000528:radiation effects; D007668:Kidney / Q000473:pathology* / Q000528:radiation effects; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011832:Radiation Injuries
D005973:Glutamine