TITLE:
Nutrition Intervention, Oral Supplementation and Healing of Leg Ulcer in Adult with Sickle Cell Disease: A Rare Case Report
AUTHORS:
Débora Frauches, Julia da Silva Gonçalves dos Santos, Renata Lanziani, Águeda Glória Sabino de Matos, André Baima, Ana Maria Mach Queiroz, Eleonora D’Ávila Thomé, Karen Cordovil
KEYWORDS:
Sickle Cell Anemia, Leg Ulcer, Malnutrition, Oral Nutritional Supplementation, Arginine
JOURNAL NAME:
Open Access Library Journal,
Vol.7 No.7,
July
27,
2020
ABSTRACT:
Leg ulcers (LU) are one of the most frequent complications in individuals with sickle cell disease (SCD). Old reports and unofficial documents found at the Nutrition Outpatient Clinic in a reference center for hematological diseases (NOC/RCHD) describe the use of oral supplement (OS) hypercaloric, hyper protein and arginine-rich (OS/HHA) for the healing of leg ulcers. The aim is to describe a rare case of a patient with sickle cell disease and leg ulcer submitted a dietetics orientations and intervention with OS/HHA. A 31-year-old male patient had been performing clinical treatment of sickle cell disease genotype SS for eight years at the RCHD of Rio de Janeiro. He had a unilateral ulcer on his right ankle for about six years, performing dressings by a Nursing team. He started follow-up at the NOC, being classified as grade III malnutrition. 13 nutrition consultations were performed during the study and 10 nutritional intervention consultations were carried out offering an OS/HHA containing 6 g/day of arginine, twice daily for 80 days. For ethical reasons, the participant was informed about the case report, agreeing and signing the consent form and the authorized image use term. Based on the analysis of food intake during the intervention period, energy consumption was on average 2.706 Kcal, including OS/HHA. Leg ulcers were found with regular margins and macerated in some areas, an ulcerated lesion with adherent and purulent exudate with 80% adherent thickness and in large quantities on the 1st day of supplementation. After eighty days, the lesion had regular margins and epithelial tissue, an ulcerative bed with 100% granulation, tissue and scarce exudate, showing improvement in healing. The patient presented an improvement in the nutritional status and leg ulcer healing. It is necessary to perform experimental research to corroborate or not the results observed in this rare case report.