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A Case of Visceral Autonomic Neuropathy Complicated by Guillain-Barre Syndrome Accompanied with Cyclic Vomiting Syndrome-like Disorder in a Child.

Hong SJ, Choe BH - Pediatr Gastroenterol Hepatol Nutr (2015)

Bottom Line: The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome.Then he started treatment with low-dose amitriptyline, which resulted in improvement.Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
We present a case of an 8-year-old boy with visceral autonomic neuropathy complicated by Guillain-Barre syndrome. In this pediatric patient, gastroparesis was the major symptom among the autonomic symptoms. Due to the gastroparesis, there was no progress with the oral diet, and nutrition was therefore supplied through a nasojejunal tube and gastrojejunal tube via Percutaneous endoscopic gastrostomy (PEG). After tube feeding for 9 months, the patient's gastrointestinal symptoms improved and his oral ingestion increased. The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome. Then he started treatment with low-dose amitriptyline, which resulted in improvement. Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

No MeSH data available.


Related in: MedlinePlus

Supine anteroposterior abdominal radiograph after percutaneous endoscopic gastrostomy insertion.
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Figure 1: Supine anteroposterior abdominal radiograph after percutaneous endoscopic gastrostomy insertion.

Mentions: Because the pediatric patient had difficulty with oral ingestion due to insertion of the tube through the nose and experienced severe psychological stress at school, the nasojejunal tube was removed about 6 months after its insertion. Percutaneous endoscopic gastrostomy (PEG) was performed, and a tube was inserted into the jejunum through the gastrostomy. Thus, nutritional support was started through the gastrojejunal tube (Fig. 1). After gastrojejunal tube feeding for 3 months, the patient's general symptoms and gastrointestinal symptoms rapidly improved, and his oral ingestion increased. The PEG was then removed following a request from the parents. The other autonomic symptoms (voiding difficulty, dizziness during voiding and defecation, and orthostatic hypotension) also gradually decreased, and they were completely improved in the end, despite slight relapses for about 6 months.


A Case of Visceral Autonomic Neuropathy Complicated by Guillain-Barre Syndrome Accompanied with Cyclic Vomiting Syndrome-like Disorder in a Child.

Hong SJ, Choe BH - Pediatr Gastroenterol Hepatol Nutr (2015)

Supine anteroposterior abdominal radiograph after percutaneous endoscopic gastrostomy insertion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493246&req=5

Figure 1: Supine anteroposterior abdominal radiograph after percutaneous endoscopic gastrostomy insertion.
Mentions: Because the pediatric patient had difficulty with oral ingestion due to insertion of the tube through the nose and experienced severe psychological stress at school, the nasojejunal tube was removed about 6 months after its insertion. Percutaneous endoscopic gastrostomy (PEG) was performed, and a tube was inserted into the jejunum through the gastrostomy. Thus, nutritional support was started through the gastrojejunal tube (Fig. 1). After gastrojejunal tube feeding for 3 months, the patient's general symptoms and gastrointestinal symptoms rapidly improved, and his oral ingestion increased. The PEG was then removed following a request from the parents. The other autonomic symptoms (voiding difficulty, dizziness during voiding and defecation, and orthostatic hypotension) also gradually decreased, and they were completely improved in the end, despite slight relapses for about 6 months.

Bottom Line: The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome.Then he started treatment with low-dose amitriptyline, which resulted in improvement.Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
We present a case of an 8-year-old boy with visceral autonomic neuropathy complicated by Guillain-Barre syndrome. In this pediatric patient, gastroparesis was the major symptom among the autonomic symptoms. Due to the gastroparesis, there was no progress with the oral diet, and nutrition was therefore supplied through a nasojejunal tube and gastrojejunal tube via Percutaneous endoscopic gastrostomy (PEG). After tube feeding for 9 months, the patient's gastrointestinal symptoms improved and his oral ingestion increased. The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome. Then he started treatment with low-dose amitriptyline, which resulted in improvement. Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

No MeSH data available.


Related in: MedlinePlus