Taylor and Dhawan correlated physical findings with nutritional deficiencies in malnourished pediatric patients. These findings can help guide additional testing and management. The authors are from King's College Hospital in London.
Patient selection: pediatric patient
Clinical Finding
Consider deficiency in
peripheral edema
protein
bone disorder with thickening of the costochondral junction
vitamin D
petechiae and/or subcutaenous hemorrhage
vitamin C and/or vitamin K
perifollicular keratosis
vitamin A
scaly rash
niacin and/or tryptophan
red scaly rash with or without hair loss
zinc
dryness and white plaque on conjunctiva
vitamin A
ophthalmoplegia
thiamine
cheilosis
vitamin B complex
angular stomatitis
vitamin B complex
glossitis
vitamin B complex
heart failure
thiamine
severe acidosis with tachypnea
thiamine
peripheral neuropathy
thiamine
myelopathy with ataxia and retinopathy
vitamin E
subacute demyelination of the spinal cord
vitamin B12
Additional findings (not listed in Table 1):
(1) anemia with pallor (iron, folate, vitamin B12)
(2) loss of skeletal muscle and fat
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