A case report on the long-term use of teduglutide in a pediatric patient with short bowel syndrome.

Short bowel syndrome (SBS) is the leading cause of intestinal failure, frequently necessitating long-term parenteral nutrition (PN). Teduglutide (TED), a glucagon-like peptide-2 analog, has demonstrated efficacy in reducing PN dependence in both adults and children. However, long-term data in pediatric populations remain limited. We present a case of a male child with SBS who underwent extensive small bowel resection at 5 days of age, resulting in a residual small bowel length of 9 cm, with the total colon and ileocecal valve preserved. Despite home PN and multiple interventions, including management of catheter-related infections and intestinal complications, PN dependence persisted. At the age of 5 years, the patient was enrolled in a TED clinical trial and continued treatment after its commercial approval. During >6 years of TED therapy, gradual and sustained reductions in PN volume and caloric intake were achieved, ultimately resulting in complete weaning from PN. Growth and nutrition status remained stable, and no severe TED-related adverse events were reported. This is the first known case documenting TED use for >6 years in a pediatric patient with SBS. Although the response was slower than in previously reported cases, long-term TED administration led to favorable outcomes, including PN independence. This case underscores the potential for TED to support intestinal adaptation over extended periods and highlights the importance of individualized, long-term treatment strategies in managing severe pediatric SBS.