Possible role of short-term parenteral nutrition with fat emulsions for development of haemophagocytosis with multiple organ failure in a patient with traumatic brain injury.
Intensive Care Med
; 19(2): 111-4, 1993.
Article
em En
| MEDLINE
| ID: mdl-7683703
ABSTRACT
We describe a case of life-threatening haemophagocytosis after a short term nutrition with fat emulsion in a 21-year-old woman who sustained an isolated traumatic brain injury. Hypertriglyceridemia and "creaming plasma" were observed after a three-day period of parenteral fat nutrition (Intralipid 20%). She also developed rash, high fever (40-41 degrees C), hypertension, raised intracranial pressure, hepatic and renal failure, haemolysis, marked thrombocyto- and leucopenia, coagulation disorder and pulmonary failure. These symptoms, together with a typical bone marrow smear, indicated haemophagocytosis with hyperactivation of the monocyte-macrophage system. We suggest that the hyperactivation was an effect of fat retention or agglutination of the fat particles; the initial triggering mechanism may emanate from the brain damage by hypercytokinaemia. The steroid treatment given most likely contributed to the successful outcome, as indicated by the stepwise improvement related in time to the steroid infusions.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
/
Histiocitose de Células não Langerhans
/
Emulsões Gordurosas Intravenosas
/
Insuficiência de Múltiplos Órgãos
Tipo de estudo:
Etiology_studies
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
1993
Tipo de documento:
Article
País de afiliação:
Suécia