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Anaemia, vitamin E deficiency and failure to thrive in an infant

I L Swann1, J R Kendra

  • 1Child Health Department, Burnley General Hospital, UK.

Insights

A baby boy with failure to thrive was diagnosed with cystic fibrosis after presenting with anemia and hemolysis. Low vitamin E levels were a key indicator in this pediatric case.

Area of Science:

  • Pediatric Hematology
  • Gastroenterology
  • Genetic Disorders

Background:

  • Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
  • Early diagnosis and management are crucial for improving patient outcomes.
  • Failure to thrive (FTT) can be an early sign of underlying conditions in infants.

Observation:

  • An 8-week-old infant presented with FTT since birth.
  • Clinical examination revealed severe anemia (6.6 g/dl) with abnormal red blood cells (polychromasia, nucleated red blood cells) and immature myeloid cells.
  • Signs of hemolysis were present, including elevated reticulocyte count (120 x 10(9)/l) and raised unconjugated bilirubin.

Findings:

  • Laboratory investigations showed low plasma protein levels and a significantly low vitamin E level.
  • These findings, in conjunction with the clinical presentation, led to the diagnosis of cystic fibrosis.

Implications:

  • This case highlights the importance of considering cystic fibrosis in infants with unexplained failure to thrive, anemia, and hemolysis.
  • Low vitamin E levels can be a critical diagnostic clue in pediatric CF cases.
  • Timely diagnosis allows for early intervention and management of CF-related complications.

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