BRIEF CLINICAL REPORT - GLUTAMINE-ENRICHED TOTAL PARENTERAL-NUTRITIONIN A PATIENT WITH RADIATION-INDUCED RENAL AND INTESTINAL FIBROSIS

This brief clinical report illustrates the case of a 50-y-old male pat ient with severe radiation-induced renal and intestinal fibrosis who r eceived glutamine-enriched total parenteral nutrition (TPN). The patie nt had end-stage renal disease and, therefore, underwent a kidney tran splant. In the postoperative course the patient developed signs of bow el obstruction and cachexia. He received two courses of glutamine-enri ched TPN before he underwent surgery for small bowel stenosis. Postope ratively, the patient received a third course of glutamine-enriched TP N. During the patient's hospital course the following indexes were mon itored: patient's weight, serum concentrations of protein, albumin, an d trialglycerol. Intestinal permeability was assessed with the lactulo se-mannitol sugar test (L-M test). We measured changes in the patient' s weight and the L-M test. We hypothesize that glutamine-enriched TPN may have been beneficial in the hospital course of this critically ill patient and may have influenced the patient's intestinal function and permeability.