Increased Resting Energy Expenditure is Associated with Failure to Thrive in Infants with Severe Combined Immunodeficiency - 14/09/11

Doi : 10.1016/j.jpeds.2011.03.041

Mary A. Barron, MSc, RD ^a,^b, Melanie Makhija, MSc, MD ^a,^c, Lorrie E.M. Hagen, RD ^a,^b, Paul Pencharz, MD, PhD ^c,^d,^e, Eyal Grunebaum, MD ^a,^c,^e, Chaim M. Roifman, MD ^a,^c,^e,^⁎
^a Division of Immunology and Allergy, The Canadian Centre for Primary Immunodeficiency, The Jeffrey Modell Research Laboratory for the Diagnosis of Primary Immunodeficiency, The Hospital for Sick Children, Toronto, Ontario, Canada
^b Department of Clinical Dietetics, Hospital for Sick Children, Toronto, Ontario, Canada
^c Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
^d Division of Gastroenterology, Hepatology and Nutrition, Physiology and Experimental Medicine Program, Research Institute and Department of Agricultural Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
^e University of Toronto, Toronto, Ontario, Canada

Reprint requests: Chaim M. Roifman, MD, 555 University Ave, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada.

Abstract

Objectives

To measure resting energy expenditure (REE) and determine whether increased REE (hypermetabolism) is associated with failure to thrive (FTT) in patients with severe combined immunodeficiency (SCID) at diagnosis.

Study design

REE was measured in 26 patients with SCID in a single transplant center. Predicted REE was determined with World Health Organization standards. Measured REE >110% of predicted REE was classified as hypermetabolism. Other data collected included FTT status, infections, genotype, phenotype, and the feeding methods used.

Results

Fifteen of 26 patients (57.7%) had FTT, and 18 of 26 patients (69.2%) were hypermetabolic. Hypermetabolism occured in 14 of 15 patients (93%) with FTT, and only 4 of 11 patients (36%) without FTT had hypermetabolism (P = .003). There was a significant difference between the measured REE (71.75 ± 16.6 kcal/kg) and the predicted REE (52.85 ± 2.8 kcal/kg; P < .0001). Eleven of 17 patients (65%) required nasogastric feeding, parenteral nutrition, or both to meet their energy needs.

Conclusions

Hypermetabolism is common in patients with SCID and may contribute to the development of FTT. The hypermetabolism in these patients may necessitate intensive nutrition support.

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Mots-clés : BMT, FTT, SickKids, IC, LAF, NG, PN, REE, SCID

Plan

Methods

Results

Failure to Thrive and Hypermetabolism

Supported by the Canadian Centre for Primary Immunodeficiency and the Jeffrey Modell Foundation. C.R. is the holder of the Donald and Audrey Campbell Chair of Immunology. The authors declare no conflicts of interest.

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Vol 159 - N° 4

P. 628 - octobre 2011 Retour au numéro

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Increased Resting Energy Expenditure is Associated with Failure to Thrive in Infants with Severe Combined Immunodeficiency - 14/09/11

Abstract

Objectives

Study design

Results

Conclusions

Plan

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