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
Specialty: Nutrition, Pedatrics