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Trace Element Status in Children with Infantile Tremor Syndrome: An Inductively Coupled Plasma-Mass Spectrometry Based Study

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Abstract

The primary objective of the study was to compare the trace element status in children with infantile tremor syndrome (ITS) with healthy controls. Blood counts, serum vitamin B12, plasma homocysteine, plasma ferritin and trace elements - magnesium, zinc and selenium were compared. Twenty-six children (11 with tremors, 14 boys, mean age 11.5 ± 3.5 mo) and 19 controls were enrolled for this study. Low vitamin B12 levels (67% vs. 5%) and elevated plasma homocysteine 96% vs. 26%) was significantly more (P < 0.001) in cases. Eight controls had hypoferritinemia, while none with ITS had it (p < 0.001). None of the children in either group had low serum levels of zinc or magnesium. Low levels of selenium were seen in six cases and five controls. This study did not show any association between the studied nutrients/ trace elements and ITS while, it showed a strong association of ITS with vitamin B12 deficiency supporting that it is a Neurocutaneous Infantile B-12 deficiency (NIB) syndrome.

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References

  1. 1.

    Kaul KK, Prasan N, Chowdhry RM. Some clinical observations and impressions on a syndrome of tremors in infants from India. J Pediatr. 1963;63:1158–66.

  2. 2.

    Goraya JS, Kaur S, Mehra B. Neurology of nutritional vitamin B12 deficiency in infants: case series from India and literature review. J Child Neurol. 2015;30:1831–7.

  3. 3.

    Gowda VK, Kolli V, Benakappa A, Srinivasan VM, Shivappa SK, Benakappa N. Case series of infantile tremor syndrome in tertiary care paediatric centre from southern India. J Trop Pediatr. 2018;64:284–8.

  4. 4.

    Garewal G, Narang A, Das KC. Infantile tremor syndrome: a vitamin B12 deficiency syndrome in infants. J Trop Pediatr. 1988;34:174–8.

  5. 5.

    Jadhav M, Webb JK, Vaishnava S, Baker SJ. Vitamin B12 deficiency in Indian infants. A clinical syndrome. Lancet. 1962;2:903–7.

  6. 6.

    Chhaparwal BC, Singh SD, Mehta S, Pohowalla JN. Magnesium levels in serum and in C.S.F. in “meningo-encephalitic syndrome” (tremor syndrome). Indian J Pediatr. 1971;38:331–3.

  7. 7.

    Vora RM, Tullu MS, Bartakke SP, Kamat JR. Infantile tremor syndrome and zinc deficiency. Indian J Med Sci. 2002;56:69–72.

  8. 8.

    Agarwal R, Singh RN, Gupta BD, Agarwal DK, Arora AK. Serum magnesium, calcium, zinc in infantile tremor syndrome. Indian Pediatr. 1993;30:374–6.

  9. 9.

    Chaudhary H, Sankhyan N, Singhi P, Attri SV, Bhatia P, Vaidya P. Infantile tremor syndrome of the tropics: a neurocutaneous syndrome of infantile B12 deficiency? Eur J Paediatr Neurol. 2017;21:e73.

  10. 10.

    Srikantia SG, Reddy V. Megaloblastic anaemia of infancy and vitamin B12. Br J Haematol. 1967;13:949–53.

  11. 11.

    Nair KM, Fernandez-Rao S, Nagalla B, et al. Characterisation of anaemia and associated factors among infants and pre-schoolers from rural India. Public Health Nutr. 2016;19:861–71.

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Author information

NS, SV, PB, PCV planned the study. Data was collected by DTF under supervision of NS and PCV. SV and PB provided lab support. All authors contributed to analysis of data and preparation of the manuscript. NS was the overall supervisor and clinician incharge and is guarantor for this paper.

Correspondence to Naveen Sankhyan.

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The authors acknowledge the support of the institute thesis grant (Post Graduate Institute of Medical Education and Research) for this work.

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Francis, D.T., Verma, S., Bhatia, P. et al. Trace Element Status in Children with Infantile Tremor Syndrome: An Inductively Coupled Plasma-Mass Spectrometry Based Study. Indian J Pediatr 87, 221–223 (2020). https://doi.org/10.1007/s12098-019-03176-z

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Keywords

  • Micronutrients
  • Nutritional deficiency
  • Cobalamin
  • Movement disorder
  • Malnutrition
  • Tropical disease