No abstract

Summarycorrelates with a decreased prostaglandin E synthesis and turnover. Sick low birth weight infants (LBWI) are prone to develop rapid onset of essential fatty acid (EFA) deficiency. EFAs serve as precursors for prostaglandins (PGs). We measured the escretion MATERIALS A N D METHODS of the major urinary metabolite of prostaglandins El and E2, 7a-hydroxy-5,ll-diketotetranorprostane-1,ldionic acid (PGE-M), PATIENTSin three EFA-deficient and in nine thriving neonates. There was Case 1. Case 1 was a full term 3600-g male infant who required no significant difference in PGE-M excretion between the sexes prolonged iv alimentation after repair of a large omphalocele. among thriving infants nor did PGE-M escretion appear to be Fluid and calories were supplied solely by the iv route for 3 affected by postconceptual age. However, a significant difference months. The solutions utilized included dextrose, electrolytes, between the PGE-,M escretion in the group of infants with EFA trace elements, vitamins, and a parentera1 alimentation mixture deficiency before and after treatment is apparent ( P < 0.05). containing FreAmine I1 (McGaw Laboratories, Glendale, CA) Significant differences in PGE-M escretion were also found be-but no fatty acids. Fluid intake varied from 100-200 ml/kg/24 hr tween the control group and the EFA-deficient infants. The sever-and calories from 22-135 cal/kg/24 hr. During the I Ith week on ity of the EFA deficiency correlates directly with the degree of parenteral nutrition the infant developed a generalized scaly erupPGs excretion. The biochemical evidences of EFA deficiency and tion which was most obvious over the forehead, face, and upper the decreased levels of PGE-M excretion are rapidly corrected anterior chest. Cutaneous application of sunflower seed oil was when patients resume a diet containing EFA. then begun and continued for 3 weeks. Improvement and resolution of the skin rash was noted within 5 days of instituting treatment (3). At 15.5 weeks of age the infant underwent colosSpeculation tomy. Healing of the surgical wound was uneventful, and the The decrease in pGE-,M excretion in patients with EFA defi-infant is currently gaining weight and doing well on a diet of oral ciency is most likely related to a decrease in the precursor EFA, Poflagen (Mead Johnson Laboratories, Evansville, IN). although P G synthetase deficiency or altered PG metabolism has Case 2. This male was born to a 20-year-old gravida 1 white not been out. Further investigation is needed into the patho-female. Estimated gestational age was 26 weeks and birthweight physio~ogic consequences of EFA deficiency as well as decreased was 800 g. The clinical course was complicated by recurrent apneic p G biosynthesis and turnover in the sick low birth weight infant. Spells requiring application of C O~~~~U O U S positive airway pressure and intermittent positive pressure breathing. Patent ductus arteriosus, congestive heart failure, necrotizing enterocolitis, hypoglyThe development of EFA deficiency has been described in cemi...