Abstract
A case is presented of transient cerebral atrophy and hyperlipidemia in an infant with kwashiorkor.
At age 2 ½ months J.H. developed feeding problems from “milk allergy”. Milk intake was reduced to 4 oz/day. Intake of baby fruits and vegetables increased to 14-16 jars/day. Anorexia with weight loss occurred over the next four months. Milk intake fell to only 4 oz/week and intake of fruits and vegetables to 4-6 jars/day. At age 8 ½ months he developed apathy, vomiting, marked pallor, generalized edema, and hepatomegaly. Weight and height had fallen from the 90th %ile to <3rd %ile. On admission total protein was 3.4 gm%, albumin 1.9 gm%, SGOT 130 mU/ml, alkaline phosphatase 340 mU/ml, LDH 744 mU/ml, bilirubin 1.7 mg%. BUN 16 mg%, and creatinine 0.5 mg%. Serum cholesterol was 334 mg%; triglycerides 1580 mg%. 24 hour urinary protein was 60 mg. Liver biopsy showed hepatocytes filled with neutral fat. Computerized tomography (CT) of the brain showed cerebral atrophy with ventriculomegaly and increases in cortical sulci, sylvian fissures and the interhemispheric fissure. After 10 weeks of feeding with infant milk formula, weight increased from 6.3 kg (<3rd %ile) to 9.3 kg (50th %ile). Hepatomegaly and edema disappeared. Serum albumin rose to 4.5 gm%; serum cholesterol and triglycerides fell to 128 mg% and 60 mg% respectively. All liver function studies returned to normal, A repeat CT scan was normal. The patient at age 13 months has a mild developmental lag.
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Raymond, Adelman, D., Dublin, A. et al. TRANSIENT CEREBRAL ATROPHY AND HYPERLIPIDEMIA IN AN INFANT WITH KWASHIORKOR FROM FOOD FADDISM. Pediatr Res 11, 440 (1977). https://doi.org/10.1203/00006450-197704000-00421
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DOI: https://doi.org/10.1203/00006450-197704000-00421