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Intestinal lengthening and growth hormone in extreme short bowel syndrome: a case report
B Velasco1, L Lassaletta, R Gracia
1Departamento de Cirugía, Hospital Infantil Universitario La Paz, Madrid, Spain.
Insights
Recombinant growth hormone (GH) successfully treated an infant with extreme short bowel syndrome after intestinal lengthening. This treatment allowed complete weaning from parenteral nutrition, showing significant nutritional improvement.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endocrinology
Background:
- Short bowel syndrome (SBS) is a malabsorptive condition often requiring long-term nutritional support.
- Recombinant human growth hormone (rhGH) has shown efficacy in promoting intestinal adaptation in adults with SBS.
- Extreme SBS in infants presents significant challenges for growth and nutritional management.
Observation:
- A case report details an infant with intestinal atresia and only 14 cm of functional bowel.
- Following a Bianchi procedure, the infant still required 50% of nutrition via parenteral route.
- A short course of rhGH (0.5 U/kg for 4 weeks) was administered.
Findings:
- The rhGH treatment led to dramatic nutritional improvement in the infant.
- Total parenteral nutrition (TPN) was successfully discontinued 2 weeks post-treatment.
- Stool frequency decreased from 7 to 2 daily, with no observed adverse effects.
Implications:
- This case suggests rhGH may be a viable therapeutic option for infants with extreme SBS.
- Further clinical trials are warranted to confirm the safety and efficacy of rhGH in this pediatric population.
- rhGH could potentially improve outcomes and reduce the burden of TPN in infants with SBS.
Abstract:
Recombinant growth hormone (GH) has been used successfully to promote mucosal intestinal adaptation in adults with short bowel syndrome. Here the authors report the case of an infant with extreme short bowel syndrome successfully treated with intestinal lengthening and GH. The patient was born with intestinal atresia leaving only 12 cm of jejunum and 2 cm of ileum with ileocecal valve. A Bianchi procedure extended the length to 25 cm, but 6 months later she still received 50% of her nutritional requirements by parenteral route. A 4-week course of 0.5 U/kg of GH dramatically changed the situation allowing weaning of total parenteral nutrition (TPN) 2 weeks after the end of the treatment with striking nutritional improvement, decrease in the number of stools from 7 to 2 per day, and no secondary effects. The authors believe that GH deserves clinical trial in cases of extreme short bowel.