Parenteral Nutrition Therapy for an Achondroplastic Patient: Case Report

Abstract

Introduction Achondroplasia is the most common form of dwarfism in humans. At the end of the twentieth century, achondroplasia had its natural history investigated and its morbimortality understood. In dwarves, obesity is one of the causes of morbidity, and it is difficult to evaluate it due to the great disproportion among anthropometric data. The characterization of the nutritional needs of these patients represents an interesting dilemma for physicians. In view of these difficulties, the present case report describes an alternative to obtain the ideal weight value of an elderly dwarf in the use of parenteral nutritional therapy. Case Report A 73-year-old male patient, carrier of achondroplastic dwarfism, was admitted for surgical treatment of colon adenocarcinoma. He was submitted to total colectomy with ileum-rectum anastomosis, evolving with abdominal septic shock by suture dehiscence, which was fixed, and a protective ileostomy was installed. Due to the maintenance of prolonged fasting, without the possibility of starting oral or enteral feeding, the patient used total parenteral nutrition. To estimate the total energy expenditure, we chose to ask the patient what his ideal weight was. The patient used total parenteral nutrition for eight days until he was able to meet his caloric needs orally. Conclusion In the absence of indirect calorimetry, the ideal weight mentioned by the patient seems to be a good option for the estimation of the caloric expenditure by simplified equations.

Impact of achondroplasia on Latin American patients: a systematic review and meta-analysis of observational studies

“…Tables 1 and 2 summarize the key characteristics from those studies that reported at least one patient-important or economic outcome. Regarding study design, four were case series [ 26 , 34 , 35 , 73 ], 24 cross-sectional studies [ 5 , 6 , 24 , 29 , 36 – 38 , 40 , 45 , 48 , 50 – 54 , 56 , 58 , 60 , 61 , 66 , 69 , 70 , 72 , 75 ], and 25 case reports [ 27 , 28 , 30 – 33 , 39 , 41 – 44 , 46 , 47 , 49 , 55 , 57 , 59 , 62 – 65 , 67 , 68 , 71 , 74 ].…”

“…Twenty-four of the included studies were conducted in Brazil [ 5 , 24 , 26 – 34 , 36 , 38 – 40 , 45 , 49 , 57 , 63 , 66 , 67 , 69 , 74 , 75 ], nine in Argentina [ 44 , 50 – 54 , 56 , 64 , 73 ], five in Colombia [ 42 , 48 , 58 , 68 , 71 ], four in Mexico [ 35 , 37 , 41 , 59 ], three in Chile [ 46 , 47 , 61 ], three in Cuba [ 43 , 60 , 65 ], one each in Dominican Republic [ 55 ], in Paraguay [ 62 ], in Venezuela [ 72 ], and in Puerto Rico [ 70 ]. Only one article [ 6 ] was a multicenter cross-sectional study, which involved nine countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Uruguay, and Venezuela) [ 6 ].…”