P024 - IMPACT OF PROPER NUTRITIONAL MONITORING ON A PATIENT WITH WASTING SYNDROME

P024

IMPACT OF PROPER NUTRITIONAL MONITORING ON A PATIENT WITH WASTING SYNDROME

L. Mauricio Garcia Japiassu^1,2,*, T. da Matta Fagundes^1,2, D. Magnoni^1,2, D. Santos Oliveira², L. Ferreira Nunes², R. Tadeu Prete²

¹Instituto de Metabolismo e Nutrição (IMeN), ²EMTN, Hospital do Coração (HCor), São Paulo, Brazil

Rationale: Consumptive syndrome, associated with cancer, results in muscle loss and malnutrition which worsen both quality of life and survival. Nutritional monitoring enables early identification of at-risk patients, allowing nutritional interventions that improve clinical outcome.

Methods: This is a case of a 70-year-old male diagnosed with Multiple Myeloma associated with paraneoplastic neurological syndrome. Laboratory showed anemia and vitamin D, zinc, folic acid, and iron deficiencies, albumin at 1.7 mg/dL and pre-albumin at 6 mg/d. He had lost over 6 kg in 3 months (current weight 66.35 kg; BMI 24.3 kg/m²; calf circumference 34 cm). Nutritional supplement targeted 25 kcal/Kg/day and 1g/Kg/day of protein but he required supplemental parenteral nutrition (PN) and enteral nutrition during hospitalization. Upon discharge, there was improvement in vitamin levels, albumin was 3.2 mg/dL, pre-albumin 19 mg/dL, he was 57 kg (BMI: 20.9 kg/m²) and calf circumference was 32.4 cm.

Results: This case describes a patient with neurological and consumptive syndromes triggered by Multiple Myeloma. He had unintentional weight loss and laboratory markers of malnutrition. Nutritional support was aimed to optimize caloric and protein intake and minimize weight loss. Over more than 4 months of hospitalization, he received nutritional therapy adjustments (both in formula composition and route) to avoid prolonged fasting and prevent nutritional depletion. Notably, early initiation of  PN, including supplementary to oral intake, optimized nutritional management.

Conclusion: We demonstrated the importance of early nutritional intervention in the management of consumptive syndrome to preserve lean body mass, improve functional status and enhance quality of life. It underscores the importance of timely and individualized nutritional support on multidisciplinary care, contributing to better clinical outcomes and reduction in malnutrition-related complication.

Disclosure of Interest: None declared