The changing of the way of feeding from percutaneous endoscopic gastronomy (PEG) to oral intake in child with Costello syndrome

Abstract

Costello syndrome is a rare genetic disorder connected with a mutations in the HRAS gene. In some children with Costello syndrome there are difficulties with breast and oral feeding. It is necessary to begin nutritional therapy by using a enteral nutrition support. The described case is a 13-years old boy diagnosed with Costello syndrome after birth as a newborn. From the beginning he was feeding by using a percutaneous endoscopic gastrostomy (PEG). In 2011, boy started a therapy focused on stimulation of facial muscles. After 18 months he began to eat by mouth. The percutaneous endoscopic gastrostomy was removed in 2014. The observed results of changing the way of feeding from PEG to oral intake were the increase of height and weight. Presumably it happened because of the difference in quality and quantity of food. It can be believed that the intestinal absorption has been improved and that the more nutrients has been passed to blood and is used to build an organism.