[Nutritional approach in systemic sclerosis: report of a case].

espanolIntroduccion: la esclerodermia es una enfermedad sistemica adquirida poco frecuente, con una patogenia compleja que compromete a numerosos organos. El abordaje nutricional no esta claramente establecido debido a su baja prevalencia. Caso clinico: presentamos el caso de una mujer de 37 anos diagnosticada de esclerodermia difusa con amplia afectacion gastrointestinal, perdida de 40% de peso desde el diagnostico y anemia grave. A pesar de la toma de suplementos orales, la nutricion a traves de gastrostomia y el uso de octreotide, no se alcanzan los requerimientos nutricionales, por lo que se plantea el uso de nutricion parenteral domiciliaria junto al resto de tratamientos. Discusion: esta paciente, la progresion de la afectacion digestiva debida a la esclerodermia hizo necesario recurrir al aporte parenteral debido a la intolerancia oral a causa de la pseudooclusion intestinal. En estos casos, la ausencia de tratamiento etiologico hace que la nutricion parenteral domiciliaria juegue un papel importante en el soporte nutricional. EnglishBackground: systemic sclerosis is a rare systemic acquired disease with a complex pathogenesis which compromises multiple organs. The nutritional approach to treat patients with this disease is not clearly stablished due to its low prevalence. Case report: we present the case of a 37-year-old woman diagnosed with systemic sclerosis with gastrointestinal compromise, 40% weight loss since diagnosis and severe anemia. Despite oral supplementation, placement of a gastrostomy feeding tube and medical therapy with octreotide, her nutritional requirements are not achieved, so we suggest home parenteral nutrition to complete the nutritional support. Discussion: the severe intestinal affection in this patient made it necessary to turn to the parenteral access because of the oral intolerance secondary to the intestinal pseudo-obstruction. In these cases, the lack of etiological treatment makes home parenteral nutrition play an important role in the nutritional approach.