Refeeding Syndrome in Children in Developing Countries Who Have Celiac Disease

Agarwal, Jaya; Poddar, Ujjal; Yachha, Surender Kumar; Srivastava, Anshu

doi:10.1097/mpg.0b013e318242fe1d

Cited by 25 publications

(20 citation statements)

References 16 publications

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“…In a study in which adolescents with anorexia nervosa were evaluated, the incidence of refeeding syndrome was noted to be 6% (13). In a study conducted in 2012 that assessed refeeding syndrome in Indian children with coeliac disease, an incidence of 14% was observed (14).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Refeeding Syndrome and Its Associated Factors in South African Children Hospitalized with Severe Acute Malnutrition

Mbethe

Mda

2017

Iran J Pediatr

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Background: The judicious use of the world health organization (WHO) guidelines in the management of severe acute malnutrition (SAM) is very crucial in avoiding complications. We investigated the incidence of refeeding syndrome and its associated factors in children under 5 years with SAM receiving treatment as inpatients. Methods: A prospective study of 104 children with SAM admitted to the paediatric unit of Dr George Mukhari Academic Hospital (a teaching hospital in Pretoria, South Africa) since March 2014 to March 2015 was conducted. On admission, history on socioeconomic status and co-morbidities, a comprehensive clinical examination, and anthropometric measurements were obtained. All the patients were managed using the 10 steps of management of malnutrition with cautious feeding and broad spectrum antibiotics being instituted. Bloods were taken for calcium, magnesium, phosphorous, urea, and electrolytes on admission and compared to repeat bloods done on day 5 post admission.

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Section: Introductionmentioning

confidence: 99%

Incidence of Refeeding Syndrome and Its Associated Factors in South African Children Hospitalized with Severe Acute Malnutrition

Mbethe

Mda

2017

Iran J Pediatr

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“…[3][4][5] In this article, we report two patients who developed RFS, one with newly diagnosed coeliac disease and another with cerebral palsy. Both patients were severely malnourished and developed the complication within days of starting feeding (Tables 1 and 2).…”

Section: Discussionmentioning

confidence: 95%

“…What might help is the sequence of events: coeliac crisis as a presentation and RFS as worsening on gluten-free diet. 5 Our second patient was chronically undernourished child with cerebral palsy and both parenteral and enteral nutrition were introduced slowly, although at higher rate (30 kcal/kg/day) than suggested in guidelines. 7 However, as this child was at high risk, RFS was suspected early, before any clinical symptoms, and diagnosed based on electrolyte disarrangements.…”

Section: Discussionmentioning

confidence: 97%

“…5,6 According to guidelines for adults published by Stanga et al 7 for patients with high risk (chronically undernourished, little or no nutritional intake for 410 days), nutritional repletion should be started even more slowly (max. 10 kcal/kg/day or even less) and gradually increased to attain optimal energy requirement over 7-10 days.…”

Section: Discussionmentioning

confidence: 99%

“…7 Although, most of the published case reports refer to adult patients, there are some recent reports on RFS occurring in children with coeliac and Crohn's disease. 5,6 We present two pediatric cases of RFS, one in a child with coeliac disease and the other one in child with cerebral palsy.…”

Section: Introductionmentioning

confidence: 98%

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Refeeding syndrome in children with different clinical aetiology

et al. 2013

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Refeeding syndrome (RFS) is a well-described state of the series of metabolic and biochemical changes that can occur during the feeding of malnourished persons. The shifts in fluids and electrolytes can lead to complications during artificial feeding, which if not recognised and untreated can lead to death. Although the physiology and pathophysiology of RFS is well known, the circumstances under which the RFS appears, clinical manifestations and management of these patients are less clear. There are few published studies describing the occurrence of RFS in children. We describe two cases of RFS in children. The first case is a boy with unrecognised coeliac disease and second case is a girl with cerebral palsy. In both cases, the RFS has developed without clinical symptoms and it was shown only through laboratory findings. Electrolyte disturbances have been successfully corrected and treatment of the underlying disease continued.

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ASPEN Consensus Recommendations for Refeeding Syndrome

Silva¹,

et al. 2020

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Introduction In the spring of 2017, the American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Committee and the Clinical Practice Committee convened an interprofessional task force to develop consensus recommendations for identifying patients with or at risk for refeeding syndrome (RS) and for avoiding and managing the condition. This report provides narrative review and consensus recommendations in hospitalized adult and pediatric populations. Methods Because of the variation in definitions and methods reported in the literature, a consensus process was developed. Subgroups of authors investigated specific issues through literature review. Summaries were presented to the entire group for discussion via email and teleconferences. Each section was then compiled into a master document, several revisions of which were reviewed by the committee. Findings/Recommendations This group proposes a new clinical definition, and criteria for stratifying risk with treatment and screening strategies. The authors propose that RS diagnostic criteria be stratified as follows: a decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%–20% (mild), 20%–30% (moderate), or >30% and/or organ dysfunction resulting from a decrease in any of these and/or due to thiamin deficiency (severe), occurring within 5 days of reintroduction of calories. Conclusions These consensus recommendations are intended to provide guidance regarding recognizing risk and identifying, stratifying, avoiding and managing RS. This consensus definition is additionally intended to be used as a basis for further research into the incidence, consequences, pathophysiology, avoidance, and treatment of RS.

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Refeeding Syndrome in Children in Developing Countries Who Have Celiac Disease

Abstract: Severely malnourished patients with celiac disease are at risk of developing potentially life-threatening refeeding syndrome, which may mimic celiac crisis, especially in developing countries. Early recognition and appropriate treatment are the keys to a successful outcome.

Cited by 25 publications

References 16 publications

Incidence of Refeeding Syndrome and Its Associated Factors in South African Children Hospitalized with Severe Acute Malnutrition

Incidence of Refeeding Syndrome and Its Associated Factors in South African Children Hospitalized with Severe Acute Malnutrition

Refeeding syndrome in children with different clinical aetiology

ASPEN Consensus Recommendations for Refeeding Syndrome

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