Enteral nutrition for severe malnutrition Crohn's disease patient: Case report

INTRODUCTION: Crohn's disease (CD) is a chronic systemic inflammatory disease with indefinite remission and relapse cycles, which can result in a high incidence rate of malnutrition. There has been increasing clinical interest in enteral nutrition (EN) as an adjunct treatment for CD. This report aims to present a case of a severely malnourished CD patient given EN support in combination with conventional infliximab (IFX) treatment. PATIENT CONCERNS: A 42-year-old CD patient with severe malnutrition. She once weighted 27.5 kg (BMI 11.4 kg/m(2)) with hyponatremia, which may cause sudden death at any time. DIAGNOSIS: In this study, the diagnosis of CD made by our gastroenterologist was based on integrating patient symptoms, radiologic findings, and biopsy results. The patient had no differential diagnosis. INTERVENTIONS: The patient received EN support and actively followed up for more than 2 years. The patient also received IFX treatment and four surgeries on an as-needed basis to manage her symptoms. OUTCOMES: The patient's inflammation and symptoms were finally improved by a combination of enteral nutrition and IFX, and her body weight increased to 44 kg. CONCLUSION: The jejunal feeding tube was the starting point of her weight gain and inflammation reduction, which allowed her adequate energy. EN may be a potential complementary therapeutic strategy to manage clinical symptoms of CD and improve severe malnutrition.