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Colegio de Medicina Interna de México.

2020, Number 3

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Med Int Mex 2020; 36 (3)

Refeeding syndrome associated with total parenteral nutrition in a patient with esophageal cancer

Martínez-Hernández L, Hernández-Gutiérrez KG, Salinas-Herrera VI, Galván-Salazar G

Language: Spanish
References: 26
Page: 424-430
PDF size: 219.32 Kb.


ABSTRACT

Background: Refeeding syndrome is described as a series of metabolic complications due to abrupt initiation of enteral or parenteral feeding in significantly malnourished patients.
Clinic case: A 60-year-old man with stage IV esophageal adenocarcinoma treated with radiotherapy and chemotherapy presented fever, neutropenia, radiation esophagitis and oropharyngeal candidiasis that caused loss of weight. He began nutritional support with parenteral nutrition (TPN), a week of having initiated TPN he presented neurological deterioration, thrombocytopenia, lack of breath and acute liver failure accompanied with hypophosphatemia, stablishing refeeding syndrome diagnosis. TPN was suspended and the clinical manifestations solved. Liver failure was diagnosed secondary to refeeding syndrome.
Conclusions: Refeeding syndrome can have metabolic, cardiovascular, hematologic, gastrointestinal and neurologic complications, the oncologist needs to be aware of the pathophysiology, risk factors and clinical manifestations, to promptly recognize this fatal metabolic disorder.


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