Laporan Kasus: Proses Asuhan Gizi Terstandar pada Anak dengan Langerhans Cell Histiocytosis (Lch) Multi Sistem on Kemoterapi Initial Treatment, Gizi Buruk Perawakan Sangat Pendek Case Report: Nutrition Care Process in Child with Langerhans Cell Histiocytosis (LCH) Multi System on Chemotherapy Initial Treatment, Severe Malnutrition with Stunting

Abstract

Langerhans Cell Histiocytosis (LCH) is an idiopathic condition characterized by abnormal proliferation langerhans cell. Malnutrition caused by disease is usually due to abnormal nutrient loss, increased energy expenditure, or decreased appetite. We herein present a case of a 2-year-old boy who was at risk of serious malnutrition after suffering from LCH a year ago. Food intake before admission to the hospital was less than the requirements (65% RDA), and the patient was classified as severe malnourished (Z-Score MUAC/A <-3SD). Examination showed anemia, hypoalbuminemia, and diarrhea. There was a visible loss of fat and muscle mass, the face looked older, baggy pants  and the appearance was  consistent with marasmus. The patient was given an extensively hydrolyzed protein formula 8x75 mL; however, due to the the increase in  diarrhea, the patient  was then given Total Parenteral Nutrition because malabsorption was suspected. Monitoring showed that the patient's intake was still below requirements but tended to increase, the frequency of diarrhea had decreased to 2 times a day, and clinical signs of malnutrition were still visible. Even though the intervention goals have not been achieved, the patient's condition is better than before the intervention.