Improvement in Intestinal-Failure-Associated Liver Disease by Using Parenteral Fish Oil as Monotherapy: Case-Based Review of the Literature
Smaragdi Fessatou,
Afroditi Kourti,
Nikolaos Zavras,
Sofia Zouganeli,
Niki Kouna,
Eustathios Stefos,
Ino Kanavaki
Affiliations
Smaragdi Fessatou
Department of Paediatric Gastroenterology, Hepatology and Nutrition, 3rd Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Afroditi Kourti
Department of Paediatric Gastroenterology, Hepatology and Nutrition, 3rd Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Nikolaos Zavras
Department of Pediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Sofia Zouganeli
Department of Nutrition and Dietetics, Attikon University General Hospital, 12462 Athens, Greece
Niki Kouna
Second Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Eustathios Stefos
Department of Paediatric Gastroenterology, Hepatology and Nutrition, 3rd Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Ino Kanavaki
Department of Paediatric Gastroenterology, Hepatology and Nutrition, 3rd Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Intestinal-failure-associated liver disease (IFALD) is a common complication of prolonged parenteral nutrition (PN). Risk factors for IFALD include clinical features, as well as medical interventions, and its management was initially based on the decrease or interruption of parenteral nutrition while increasing enteral nutrition. However, the tolerance of full enteral nutrition in children with intestinal failure may require prolonged intestinal rehabilitation over a period of years. As a consequence, infants unable to wean from PN are prone to develop end-stage liver disease. We describe the case of an infant receiving long-term PN who was diagnosed with IFALD wherein we were able to reverse IFALD by switching lipid emulsions to fish oil monotherapy. A systemic review of case reports and case series on reversing IFALD using fish oil lipid emulsion follows the case description.
