The Indian Journal of Pediatrics

, Volume 86, Issue 6, pp 548–550 | Cite as

Intestinal Failure-Associated Liver Disease and Eicosapentaenoic Acid/Arachidonic Acid Ratio

  • Wataru Miura
  • Nobuhiko NaganoEmail author
  • Ryota Kato
  • Aya Okahashi
  • Kayo Yoshikawa
  • Kensuke Ohashi
  • Tsugumichi Koshinaga
  • Ichiro Morioka
Clinical Brief


Intestinal failure-associated liver disease (IFALD) is a fatal complication of short bowel syndrome managed with parenteral nutrition. A clinical cohort study reported the usefulness of parenteral administration of fish-derived omega-3 fatty acids in improving IFALD; however, no biomarker has been developed as yet. The authors report the case of a preterm infant with IFALD complicated by extensive short bowel syndrome. Intravenous administration of omega-3 fatty acids were introduced using Omegaven®at the age of 4 mo for IFALD. The IFALD improved with an increase in Eicosapentaenoic acid (EPA)/ Arachidonic acid (AA) ratio (from 0.08 to 1.99) 7 d after the intravenous treatment. It is important to administer omega-3 fatty acids intravenously at an early stage for IFALD associated with extensive short bowel syndrome. A low EPA/AA ratio may be a serum marker of disease activity in IFALD.


Intestinal failure-associated liver disease Severe short bowel syndrome Omega-3 fatty acids Intravenous administration Eicosapentaenoic acid/Arachidonic acid ratio 


Authors’ Contribution

WM, and NN: Drafted the initial manuscript. WM, NN, RK, AO, KY, KO, TK: Cared for the patient and collected the clinical samples or data; WM, NN, AO, KY, IM: Interpreted the data. IM revised the article critically for important intellectual content. All authors contributed to the intellectual content of this manuscript and approved the final manuscript as submitted. IM will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



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Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of Pediatrics and Child HealthNihon University School of MedicineTokyoJapan
  2. 2.Department of Pediatric SurgeryNihon University School of MedicineTokyoJapan

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