Essential fatty acid deficiency in infants induced by fat-free intravenous feeding

Abstract

In a series of infants with whom prolonged total intravenous alimentation was required, the effects of such a fat-free regimen upon fatty acid composition of serum lipids has been measured serially. Essentially fatty acid deficiency was induced by the fat-free regimen within a few days, as evidenced by diminished 18:2 and 20:4 and elevated 16:1, 18:1, and 20:3 in the serum lipids. Subsequent feeding of small oral doses of methyl linoleate caused small changes in the fatty acid pattern in the direction of normalcy, but oral feeding of a normal formula diet restored the fatty acid pattern to normal. One case, maintained on fat-free intravenous feeding for 4.5 months, developed severe dermal lesions and the ratio of 20:3/20:4 in serum phospholipids reached 18, the most extreme value thus far observed in animals or man. Tissues from this case obtained at autopsy revealed the same abnormal pattern of fatty acids in triglycerides and phospholipids as was found in the serum lipids, confirming the extreme EFA deficiency.