JPGN Reports · 3 authors, 2 centres
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A case report of a 23-week premature infant with short bowel syndrome who developed severe essential fatty acid deficiency after intravenous lipid emulsions were withheld and then suboptimally dosed. Treatment with 100% fish oil intravenous lipid emulsion at 1.5 g/kg/d over 16 weeks normalized the triene:tetraene ratio, transaminases, and conjugated bilirubin.
This case report describes an extremely premature infant born at 23 weeks gestational age who developed necrotizing enterocolitis, short bowel syndrome, intestinal failure-associated liver disease, and cytomegalovirus infection. One hundred percent fish oil intravenous lipid emulsion was prescribed at 1.5 g/kg/d to treat the essential fatty acid deficiency, hypertriglyceridemia, and intestinal failure-associated liver disease. By 21 weeks of age, after 16 weeks of 100% fish oil intravenous lipid emulsion, the triene:tetraene ratio and transaminases normalized, and conjugated bilirubin was less than 2 mg/dL. Growth failure and microcephaly persisted despite improvement in liver function. The case demonstrates that essential fatty acid deficiency can paradoxically exacerbate hypertriglyceridemia and that intravenous lipid emulsions should be given consistently at appropriate doses in premature infants.
