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The fat overload syndrome. Report of a case and literature review
Insights
Infants with intestinal mucosal hypoplasia can develop fat overload syndrome from intravenous fat emulsion. This condition requires careful management including dose reduction and nutritional adjustments.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Nutrition
- Clinical Case Study
Background:
- Parenteral nutrition is crucial for infants with intestinal failure.
- Intravenous fat emulsions (IVFEs) are essential components of parenteral nutrition.
- Infants with compromised gastrointestinal function are at risk for complications.
Observation:
- A 10-month-old infant with intestinal mucosal hypoplasia received IVFEs at 5 g/kg/day for five weeks.
- The infant developed symptoms including fever, jaundice, easy bruisability, elevated transaminases, conjugated hyperbilirubinemia, and coagulopathy.
Findings:
- The clinical presentation was consistent with fat overload syndrome.
- The infant's condition resolved after temporary cessation of parenteral nutrition and subsequent cautious reintroduction of nutrients at lower fat dosages.
Implications:
- This case highlights the importance of monitoring for fat overload syndrome in infants receiving IVFEs.
- Careful titration of IVFE dosage is critical in infants with intestinal mucosal hypoplasia.
- Early recognition and management can prevent severe complications associated with fat overload syndrome.
Abstract:
A 10-month-old infant with hypoplasia of the intestinal mucosa had the fat overload syndrome develop while receiving intravenous fat emulsion at a dosage of 5 g/kg/day of fat for five weeks. This syndrome was characterized by fever, jaundice, easy bruisability, increased levels of serum transaminases, conjugated hyperbilirubinemia, and abnormal results of clotting studies. Management consisted of withdrawal of parenteral nutrition for 72 hours, followed by gradual reinstitution of protein and subsequent introduction of fat at a lower dosage.