Iron overload in patients with Crohn's disease with short bowel syndrome who received long-term parenteral nutrition with trace elements

BMJ Case Rep. 2024 Jan 25;17(1):e254612. doi: 10.1136/bcr-2023-254612.

Abstract

Crohn's disease patients often need regular home parenteral nutrition (HPN) for intestinal failure due to multiple intestinal resections. Trace elements are necessary for long-term HPN but the requirement volume of iron is undetermined. We describe three patients with Crohn's disease with short bowel syndrome (SBS) who had iron overload as a result of long-term HPN including iron. Serum ferritin level was significantly decreased through depleting intravenous iron administration in all cases. One patient needed regular insulin injection and phlebotomy for diabetes mellitus due to hemochromatosis, and intravenous iron administration had a significant impact on the patient's health. Long-term routine intravenous iron administration should be cautious in SBS patients to avoid the overload.

Keywords: Crohn's disease; Parenteral / enteral feeding; Small intestine.

Publication types

  • Case Reports

MeSH terms

  • Crohn Disease* / complications
  • Crohn Disease* / surgery
  • Humans
  • Iron
  • Iron Overload* / etiology
  • Parenteral Nutrition, Home*
  • Short Bowel Syndrome* / complications
  • Short Bowel Syndrome* / therapy
  • Trace Elements* / therapeutic use

Substances

  • Trace Elements
  • Iron