The Turkish Journal of Pediatrics 2016 , Vol 58 , Num 2
Stepwise diet management in pediatric gastrointestinal graft versus host disease
Nevra Koç 1 ,Mehmet Gündüz 1 ,M Fatih Azık 2 ,Betül Tavil 2 ,Dilek Gürlek-Gökçebay 2 ,Eda Özaydın 1 ,Bahattin Tunç 2 ,Duygu Uçkan 3
1 Pediatric Nutrition and Metabolism, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey
2 Pediatric Hematology, Department of Pediatrics, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey
3 Hematopoietic Stem Cell Transplantation Unit, Ministry of Health, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey
DOI : 10.24953/turkjped.2016.02.004 Gastrointestinal tract is one of the major systems affected by graft-versus-host disease (GVHD). Injury to the gut during conditioning therapy before stem-cell transplantation (SCT) plays a pivotal role in the initiation of inflammatory stimuli. We reviewed medical records of the patients who underwent SCT between April 2010 and June 2013 in our center. A stepwise upgrade diet was given to the children with acute GI-GVHD (Gastrointestinal GVHD) including parenteral and enteral nutrition. A total of 105 patients underwent SCT and seven patients developed grade III-IV acute GI-GVHD. Total parenteral nutrition (TPN) was initiated to all patients after the diagnosis of GI-GVHD and minimal enteral nutrition (1-2 ml/kg/day standard pediatric enteral formula/special meat soup) was given to the patients. GI-GVHD improved in all patients with no change in body weight, and recovery to a normal diet took 10-30 days. Stepwise diet management of oral nutrition contributed to rapid improvement of grades III-IV acute GI-GVHD. Keywords : gastrointestinal graft versus host disease, diet management, hematopoeietic stem cell transplantation, children
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