Objective:To describe the case of two siblings with severe protein-calorie malnutrition due
to abuse by starvation.Cases description:The two patients were simultaneously referred to the Hospital Municipal, where
they were admitted to the Pediatric Gastroenterology clinic of a university
hospital for diagnostic investigation of the cause of severe malnutrition and
screening tests for Celiac Disease, Cystic Fibrosis and Environmental enteropathy
among others. The exams were all normal, and after detailed research on the
interactions of this family, we reached the conclusion that the malnutrition was
due to abuse by starvation. The children spent approximately two months in the
hospital, receiving a high-protein and high-calorie diet, with significant
nutritional recovery.Comments:Abuse by starvation, although rare, should always be considered of as one of the
causes of child malnutrition and pediatrician should be aware of the child's
development, as well as the family interactions, to prevent more severe
nutritional and emotional consequences in the future.