Nutritional Therapy in Pyoderma Gangrenosum patients due to Inflammatory Bowel Disease Nur Fitriana (a), Suryani Asad (b)
(a) Clinical Nutrition Specialist Program, Hasanuddin University School of Medicine, Indonesia
(b) Department of Nutrition, Hasanuddin University School of Medicine, Indonesia
Abstract
Pyoderma gangrenosum is an inflammatory disorder characterized by chronic and recurrent skin ulcers with necrolytic margins. Pyoderma gangrenosum is often associated with systemic inflammatory conditions most often it is inflammatory bowel disease. The aim of nutritional therapy in this patients was to fulfill macronutrients and micronutrients, reduce inflammation, and nutritional status.This case reported a woman 53 years old, admitted to hospital with diarrhea accompanied by ulcers on the legs, knees, spine and limitations in carrying out daily activities. with a diagnosis of pyoderma gangrenosum due to inflammatory bowel disease and malnutrition, anemia (9,4 g/dL), leukocytosis (14.790/ml), trombositosis (602.000/ml), hypoalbuminemia (2,3g/dL), hyponatremia (132 mmol/L), hypokalemia (2,9 mmol). Nutritional therapy was given with total energy 1600 kcal and increased graduall 1800 kcal, protein 1,5-2 g/kg IBW/day, carbohydrates 50-55% and fat 30-35%. Suplementation were vitamin B complex / 8 hour, zinc 20 mg/ 24 hour, vitamin C 250 mg/12 hour, vitamin A 6000 iu/ 24 hour and snake head fish extract high content protein albumin (Pujimin 2 capsule/8 hour ). After 28 days , there were clinical and metabolic improvement in anemia (9,4 to 10,5 g/dL) leukocyte (14790 to 7830 /ul), trombositosis (602.000 to 348.000 g/dL) albumin (2,3 to 3,3 g/dL), sodium (132 to 143 mmol/L), and potassium (2,9 to 4,3 mmol/L). In conclusion, nutritional therapy with adequate macronutrients and micronutrients can improve nutritional status and quality of life, the ability to carry out daily activities from mild dependent to be independent in pyoderma gangrenosum patients.
