Mohamed Shahd A, Gamage Manoji, Parker Richard, Brown Rachel M, Cooper Sheldon C
Department of Gastroenterology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Department of Histopathology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Nutr Clin Pract. 2025 Oct;40(5):1212-1218. doi: 10.1002/ncp.70005. Epub 2025 Jul 31.
Up to 65% of patients receiving parenteral nutrition (PN) have intestinal failure-associated liver disease (IFALD) and ~25% will have fibrosis on biopsy. First-generation lipid injectable emulsions (ILEs) are considered a greater risk factor for IFALD compared with newer formulations. We describe a case report of an adult patient with intestinal failure receiving PN who had improvement of liver function tests (LFTs) and regression of fibrosis on liver biopsy following a switch from 100% soybean oil (SO) ILE to SO, medium-chain triglyceride, olive oil, and fish oil ILE. This supports the only other existing adult case report in the literature to date, which showed histological improvement but no improvements in LFTs.
接受肠外营养(PN)的患者中,高达65%患有肠衰竭相关肝病(IFALD),约25%的患者活检显示有纤维化。与新型制剂相比,第一代脂质注射乳剂(ILEs)被认为是IFALD的更大风险因素。我们描述了一例成年肠衰竭患者接受PN的病例报告,该患者在从100%大豆油(SO)ILE转换为SO、中链甘油三酯、橄榄油和鱼油ILE后,肝功能检查(LFTs)有所改善,肝脏活检显示纤维化消退。这支持了迄今为止文献中仅有的另一例现有成人病例报告,该报告显示组织学有所改善,但LFTs无改善。