(a) Clinical Nutrition Specialist Program, Department of Nutrition, Hasanuddin University School of Medicine, Indonesia
(b) Department of Nutrition, Hasanuddin University School of Medicine, Indonesia
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by production of autoantibodies directed against nuclear (anti-dsDNA, anti-Sm, anti-RNP) and cytoplasmic antigens affecting several organs and tissues. The aim of nutritional therapy in this patients was to fulfill macronutrients and micronutrients, reduce inflammation, improve the immune system and nutritional status. This case reported a woman 37 years old with history of joint pain since the last 2 years, admitted to hospital with diarrhea and vomiting more than 3 times a day and seizure before loss of consciousness was diagnosed with SLE ACR 6/10 SLEDAI score 18 with decubitus ulcer grade 4, moderate malnutrition, anemia (7,4 g/dL), immune system depletion (Total Lymphocyte Count/TLC 460,6 /ul), hypoalbuminemia (2,7 g/dL), , and severe hypokalemia (2,3 mmol/L). Nutritional therapy was given with total energy 1600 kcal and increased gradually, protein 1,5-2 g/kg IBW/day, carbohydrates 50% and fat 29-32%. Anemia has been corrected with adequate intake and blood transfusion and hypokalemia has been corrected by giving refeeding syndrome therapy because it is accompanied by hypomagnesemia 1.17 meq which is corrected by administering antacids, and KCl iv and maintained with KSR tablets, accompanied by supplementation of vitamin B complex. Vitamin A, Vitamin C, vitamin D, zinc, curcuma, fish oil and snake head fish extract high content protein albumin. After 50 days of nutritional intervention, there were clinical and metabolic improvements marked by laboratory results including anemia (7.4 to 9.2 g / dL), TLC (460 to 1200 /ul), albumin (2.7 to 3.1. g / dL), and potassium (2,3 to 4,2 mmol / L). In conclusion, adequate nutritional therapy with macronutrients and micronutrients can improve nutritional status and quality of life in SLE
