Korean J Pediatr Gastroenterol Nutr.  2007 Mar;10(1):60-65.

Copper Deficient Anemia in Severe Protein-EnergyMalnutrition due to Child Abuse

Affiliations
  • 1Department of Pediatrics, Bundang Jesaeng General Hospital, Sungnam, Korea. babydr@chol.com

Abstract

An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

Keyword

Malnutrition; Child abuse; Anemia; Copper deficiency

MeSH Terms

Anemia*
Appetite
Child
Child Abuse*
Child*
Child, Preschool
Copper*
Extremities
Female
Fever
Hair
Humans
Intensive Care Units
Iron
Liver
Liver Diseases
Malnutrition
Parents
Pneumonia
Protein-Energy Malnutrition
Rehabilitation
Skin
Zinc
Copper
Iron
Zinc
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