Pancreatic Enzyme Replacement Therapy in Children with Severe Acute Malnutrition: A Randomized Controlled Trial

• Published in: The Journal of pediatrics 2017-11, Vol.190, p.85-92.e2
• Main Authors: Bartels, Rosalie H., Bourdon, Céline, Potani, Isabel, Mhango, Brian, van den Brink, Deborah A., Mponda, John S., Muller Kobold, Anneke C., Bandsma, Robert H., Boele van Hensbroek, Michael, Voskuijl, Wieger P.
• Format: Article
• Language: English
• Subjects: Body Weight; Child, Preschool; Enzyme Replacement Therapy - methods; exocrine pancreatic insufficiency; Exocrine Pancreatic Insufficiency - therapy; fecal elastase-1; Female; free fatty acid; global health; Humans; Infant; Infant Mortality; Length of Stay; Malawi; Male; Pancreas; Pilot Projects; Prospective Studies; Severe Acute Malnutrition - therapy; Treatment Outcome; triglycerides; Weight Gain
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2017.07.013

To assess the benefits of pancreatic enzyme replacement therapy (PERT) in children with complicated severe acute malnutrition. We conducted a randomized, controlled trial in 90 children aged 6-60 months with complicated severe acute malnutrition at the Queen Elizabeth Central Hospital in Malawi. All children received standard care; the intervention group also received PERT for 28 days. Children treated with PERT for 28 days did not gain more weight than controls (13.7 ± 9.0% in controls vs 15.3 ± 11.3% in PERT; P = .56). Exocrine pancreatic insufficiency was present in 83.1% of patients on admission and fecal elastase-1 levels increased during hospitalization mostly seen in children with nonedematous severe acute malnutrition (P