Infantile “meningo-encephalitic” syndrome

Pohowalla, J. N.; Kaul, K. K.; Bhandari, Naleen Raj; Singh, S. D.

doi:10.1007/bf02896818

Cited by 27 publications

(20 citation statements)

References 2 publications

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“…Anemia was mild to moderate, as was observed by Pohowalla (1960). [ 9 ] The peripheral smear revealed mostly dimorphic picture followed by macrocytic and microcytic anemia, as observed in other studies. [ 11 15 18 ] Vitamin B12 levels were low in 50%, similar to Goraya and Kaur[ 11 ] Normal levels in the remaining 50% strengthens the belief that Vitamin B12 deficiency is not the only factor that plays a role in ITS.…”

Section: Discussionsupporting

confidence: 74%

“…In the present study, the age of presentation was 6–18 months with mean, SD of 11, 3.1 months which was similar to that reported in other studies. [ 7 8 9 ] Number of males were more than females, as was seen in earlier studies. [ 8 10 11 ] We observed that cases were present throughout the year, with two peaks in the months of May and November which is similar to Ghai,[ 1 ] Sharda and Bhandari,[ 12 ] but contrary to Charles et al .,[ 8 ] Sirolia and Arya[ 7 ] Majority of patients were from a rural background and lower middle socioeconomic status, as was observed by Bajpai et al .…”

Section: Discussionsupporting

confidence: 66%

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Infantile tremor syndrome in modern times

et al. 2017

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Background:Infantile tremor syndrome (ITS) is a clinical syndrome of acute or gradual onset of mental and psychomotor changes, pigmentary disturbances of hair and skin, pallor, and tremors in malnourished children aged between 5 months and 3 years. It is a well-known entity, but the exact etiopathogenesis is still not known.Setting and Design:Prospective observational study carried out in the Department of Pediatrics at Dr RPGMC Tanda, Kangra in Himachal Pradesh.Materials and Methods:Demographic, clinical, and laboratory profile of 25 children with the diagnosis of preinfantile and ITS was collected who were admitted from May 2014 to June 2015.Statistical Analysis:Descriptive analysis was performed using SPSS 17 trial version.Results:These children accounted for 0.5% of total pediatric admissions. Median, standard deviation age was 10, 3.1 months. Male to female ratio was 1.27:1. Cases were present throughout the year with two peaks observed in the months of May and November. This disease was found to be more common in higher birth order (68%). Complementary feeding, that too improper, was initiated in only 4 cases (16%). Ninety-six percent cases presented with comorbid illnesses. Respiratory tract infection was the most common association, followed by urinary tract infection. There was moderate anemia with dimorphic picture (40%). Thirteen (52%) had vitamin B12 levels below normal. Magnesium levels, though statistically insignificant (P = 0.8) were lower in patients with tremors.Conclusion:This is a disease of multi-micronutrient deficiency, which can be present either alone or in association. Educating women about proper nutrition during pregnancy and timely administration of complementary feeding is of utmost importance.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 66%

Infantile tremor syndrome in modern times

et al. 2017

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“…Pohowalla et al ., in their case series, did not notice megaloblastic anemia in any of the participants. [ 5 ] In another study, megaloblastic bone marrow was found in 23% cases of whom 66% were put on Vitamin B12 in the dose of 100–200 µg/day, but none of them showed any clinical improvement after 15 days of treatment. [ 6 ] We also treated our B12 deficient ITS patients with parenteral Vitamin B12 in the dose of 1000 µg in divided doses followed by oral therapy.…”

Section: Discussionmentioning

confidence: 99%

“…did not notice megaloblastic anemia in their study. [ 5 ] In another study, megaloblastic bone marrow was found in one-fourth of cases, but none of the cases had shown any clinical improvement after 15 days of the treatment with Vitamin B12. [ 6 ] In another study, Vitamin B12 was administered intramuscularly in doses of either 50 or 100 µg in 17 cases of ITS.…”

Section: Introductionmentioning

confidence: 99%

Infantile tremor syndrome: Role of Vitamin B12 revisited

et al. 2016

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Objective:To study the role of Vitamin B12 as an etiological factor in patients of infantile tremor syndrome (ITS).Methods:Twelve consecutive admissions of children diagnosed clinically as ITS were assessed. Assessment was done using a predefined pro forma to document patient demographic factors, general examination, systemic examination as well as relevant hematological and biochemical investigations.Results:Out of the 12 cases of ITS, 6 were males and 6 were females. Two cases had serum B12 levels below reference values, five had levels in low normal range, and remaining five had normal values.Conclusions:Role of Vitamin B12 deficiency as an etiological factor in the patients of ITS is inconclusive.

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“…Wokes (1957) found that infants of 'vegans' did not show any evidence of vitamin B12 deficiency as long as they were on breast milk but these symptoms appeared after weaning on to low protein diets and were controlled by cow's milk. Recently, a syndrome characterized by anaemia, abnormal skin pigmentation, mental retardation, and tremors has been described among Indian infants of 4-11 months (Dikshit, 1957;Pohowalla et al, 1960;Kaul, Prasan, and Chowdhry, 1963;Jadhav et al, 1962;Srikantia and Reddy, 1967). The bone-marrow in such infants usually showed megaloblastic erythropoiesis, and the serum vitamin B12 levels were low.…”

Section: Discussionmentioning

confidence: 99%