Propuesta de abordaje nutricional integral en paciente joven con enfermedad autoinmune sistémica y compromiso gastrointestinal crónico.

Abstract

Systemic lupus erythematosus and Sjögren disease are chronic multisystem autoimmune disorders that may coexist with gastrointestinal manifestations, hematologic abnormalities, fatigue, xerostomia, and renal involvement. Persistent inflammation, digestive symptoms, glucocorticoid exposure, and immunotherapy increase the risk of inadequate intake, loss of muscle mass, micronutrient deficiencies, electrolyte disturbances, and food-safety complications. This study aimed to structure a comprehensive, progressive, and measurable nutritional intervention for a complex clinical case involving autoimmune overlap and chronic gastrointestinal impairment. An applied case-study design was used, integrating the Nutrition Care Process, NRS-2002/MUST screening, Subjective Global Assessment, and GLIM criteria with current clinical nutrition, gastroenterology, rheumatology, and nephrology guidelines. The proposal was organized into five phases: assessment, stabilization, early discharge, lean-mass recovery, and maintenance. Key priorities included small frequent meals, cooked foods and adapted textures, adequate protein adjusted to renal function, sodium control, correction of deficiencies, prevention of refeeding syndrome, and family education. Nutritional care should be incorporated early into interdisciplinary management and monitored through anthropometric, functional, dietary, clinical, and biochemical indicators.