Quan Jiao, Liu Xiao-Feng, Hu Ke, Hou Qian
Department of Nutrition, Xiangya Hospital, Central South University, Changsha 410008, China (Hou Q, Email: qhou2005@163. com).
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Dec 15;25(12):1270-1275. doi: 10.7499/j.issn.1008-8830.2306148.
To summarize the clinical characteristics and nutrition therapy for children with lysinuric protein intolerance (LPI).
The clinical manifestations, laboratory test results and enteral nutrition treatment in a girl with LPI diagnosed in Xiangya Hospital, Central South University were retrospective analyzed. Additionally, the data of the children with LPI reported in China and overseas were reviewed.
A case of 4-year-old girl was presented, who exhibited significant gastrointestinal symptoms, such as chronic abdominal distension, prolonged diarrhea, recurrent pneumonia, and limited growth. She had a poor response to anti-infection treatment. After receiving enteral nutrition therapy, she did not experience any gastrointestinal discomfort, and there were improvements in the levels of hemoglobin, albumin, and blood ammonia. Unfortunately, due to serious illness, she declined further treatment and later passed away. A total of 92 cases of pediatric patients with LPI have been reported to date, including one case reported in this study. Most children with LPI experienced disease onset after weaning or introduction of complementary foods, presenting with severe digestive system symptoms, malnutrition, and growth retardation. It is noteworthy that only 50% (46/92) of these cases received nutritional therapy, which effectively improved their nutritional status. Among the 92 children, 8 (9%) died, and long-term follow-up data were lacking in other reports.
LPI often involves the digestive system and may result in growth restriction with a poor prognosis. Nutritional therapy plays a crucial role in the comprehensive treatment of LPI.
总结赖氨酸尿性蛋白不耐受(LPI)患儿的临床特征及营养治疗。
回顾性分析中南大学湘雅医院确诊的1例LPI女童的临床表现、实验室检查结果及肠内营养治疗情况。此外,还对国内外报道的LPI患儿资料进行了复习。
报道1例4岁女童,有明显的胃肠道症状,如慢性腹胀、迁延性腹泻、反复肺炎及生长受限,抗感染治疗效果不佳。接受肠内营养治疗后,未出现任何胃肠道不适,血红蛋白、白蛋白及血氨水平有所改善。遗憾的是,因病情严重,患儿拒绝进一步治疗,随后死亡。迄今为止,共报道92例儿童LPI患者,包括本研究报道的1例。大多数LPI患儿在断奶或添加辅食后发病,表现为严重的消化系统症状、营养不良及生长发育迟缓。值得注意的是,这些病例中仅50%(46/92)接受了营养治疗,有效改善了营养状况。92例患儿中,8例(9%)死亡,其他报道缺乏长期随访数据。
LPI常累及消化系统,可导致生长受限,预后不良。营养治疗在LPI的综合治疗中起关键作用。