Yonsei Med J.  2014 Jan;55(1):264-269. 10.3349/ymj.2014.55.1.264.

Nutritional Outcomes in Children with Epidermolysis Bullosa: The Experiences of Two Centers in Korea

• Kim KY
• Namgung R
• Lee SM
• Kim SC
• Eun HS
• Park MS
• Park KI
• Lee C

• KMID: 1779915
• DOI: http://doi.org/10.3349/ymj.2014.55.1.264

Abstract

PURPOSE
Epidermolysis bullosa (EB) is associated with variable risks of extracutaneous manifestations and death. Currently, there is limited information on the clinical course and prognosis of EB in Korea. This study analyzed the nutritional outcomes, clinical morbidity, and mortality of children with EB.
MATERIALS AND METHODS
Thirty patients, admitted to Severance Hospital and Gangnam Severance Hospital, from January 2001 to December 2011, were retrospectively enrolled. All patients were diagnosed with EB classified by dermatologists.
RESULTS
Among the 30 patients, 5 patients were diagnosed with EB simplex, four with junctional EB, and 21 with dystrophic EB. Wound infection occurred in 47% of the patients, and blood culture-proven sepsis was noted in 10% of the patients. Two (9.2%) patients had esophageal stricture and 11 (52.4%) of the dystrophic EB patients received reconstructive surgery due to distal extremity contracture. There were five mortalities caused by sepsis, failure to thrive, and severe metabolic acidosis with dehydration. According to nutrition and growth status, most of the infants (97%) were born as appropriate for gestational age. However, at last follow-up, 56% of the children were below the 3rd percentile in weight, and 50% were below the 3rd percentile in weight for height. Sixty percent of the children had a thrive index below -3.
CONCLUSION
Postnatal growth failure is a serious problem in children with EB. Strategies to maximize nutritional support could alleviate growth failure in children with EB, and thus improve clinical outcomes.

Keyword

Epidermolysis bullosa; nutritional outcome; growth failure

MeSH Terms

Birth Weight/physiology
Epidermolysis Bullosa/*physiopathology
Female
Humans
Infant, Newborn
Korea
Male
Pregnancy
Republic of Korea
Retrospective Studies

Figure

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  Fig. 1 For children with EB, thrive index at last follow-up plotted against weight standard at birth, reflecting poor weight gain as a negative index. Thrive index was not related to weight standard deviation score (SDS) at birth, and was not different between infection and non-infection subgroups. Black circles indicate EB patients with infection and open circles represent those without infection. EB, epidermolysis bullosa.

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